Provider Demographics
NPI:1760561302
Name:PEASE, JAMES S (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:S
Last Name:PEASE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:200 LINCOLN ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2528
Mailing Address - Country:US
Mailing Address - Phone:508-756-0111
Mailing Address - Fax:855-852-6434
Practice Address - Street 1:200 LINCOLN ST
Practice Address - Street 2:SUITE 4
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2528
Practice Address - Country:US
Practice Address - Phone:508-756-0111
Practice Address - Fax:508-756-0222
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2017-06-15
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Provider Licenses
StateLicense IDTaxonomies
MAMA41411207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1580712OtherCIGNA
MA041411OtherTUFTS
MA3009033Medicaid
MAJ05488OtherBLUE CROSS
MA70895OtherHARVARD PILGRIM
MA93130OtherFALLON
MA3009033Medicaid
MA041411OtherTUFTS