Provider Demographics
NPI:1790732154
Name:STARR, STEPHEN D (MD)
Entity Type:Individual
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First Name:STEPHEN
Middle Name:D
Last Name:STARR
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Gender:M
Credentials:MD
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Mailing Address - Street 1:354 W BOYLSTON ST
Mailing Address - Street 2:SUITE 224
Mailing Address - City:WEST BOYLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01583-2373
Mailing Address - Country:US
Mailing Address - Phone:508-756-0470
Mailing Address - Fax:508-756-0471
Practice Address - Street 1:354 W BOYLSTON ST
Practice Address - Street 2:SUITE 224
Practice Address - City:WEST BOYLSTON
Practice Address - State:MA
Practice Address - Zip Code:01583-2373
Practice Address - Country:US
Practice Address - Phone:508-756-0470
Practice Address - Fax:508-756-0471
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2011-12-20
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Provider Licenses
StateLicense IDTaxonomies
MA2177632084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA3613601Medicare PIN