Provider Demographics
NPI:1790747442
Name:CHILD, STEPHEN T (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:T
Last Name:CHILD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:76 WHITNEY RD
Mailing Address - Street 2:
Mailing Address - City:HARVARD
Mailing Address - State:MA
Mailing Address - Zip Code:01451-1403
Mailing Address - Country:US
Mailing Address - Phone:978-456-9030
Mailing Address - Fax:978-514-8705
Practice Address - Street 1:50 MEMORIAL DR
Practice Address - Street 2:SUITE 210
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2238
Practice Address - Country:US
Practice Address - Phone:978-514-8704
Practice Address - Fax:978-514-8705
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2020-11-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA73561207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine