Provider Demographics
NPI:1578644381
Name:MORIN, CHARLES R (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:R
Last Name:MORIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:549 COLUMBIAN ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1138
Mailing Address - Country:US
Mailing Address - Phone:781-682-6153
Mailing Address - Fax:781-849-9779
Practice Address - Street 1:549 COLUMBIAN ST
Practice Address - Street 2:SUITE 208
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1138
Practice Address - Country:US
Practice Address - Phone:781-682-6153
Practice Address - Fax:781-849-9779
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2012-11-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA805682084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3098443Medicaid
MAY02892Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER