Provider Demographics
NPI:1700842952
Name:LARSEN, P REED (MD)
Entity Type:Individual
Prefix:
First Name:P
Middle Name:REED
Last Name:LARSEN
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:77 AVENUE LOUIS PASTEUR
Mailing Address - Street 2:HARVARD INSTITUTES OF MEDICINE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-525-5150
Mailing Address - Fax:617-731-4718
Practice Address - Street 1:77 AVENUE LOUIS PASTEUR
Practice Address - Street 2:HARVARD INSTITUTES OF MEDICINE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-525-5150
Practice Address - Fax:617-731-4718
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2012-05-04
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Provider Licenses
StateLicense IDTaxonomies
MA37485207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2038676Medicaid