Provider Demographics
NPI:1801865233
Name:DEAMICIS, RICHARD ALFRED (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALFRED
Last Name:DEAMICIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4 COURTHOUSE LN
Mailing Address - Street 2:SUITE 9
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-1728
Mailing Address - Country:US
Mailing Address - Phone:978-459-8400
Mailing Address - Fax:978-459-2345
Practice Address - Street 1:4 COURTHOUSE LN
Practice Address - Street 2:SUITE 9
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-1728
Practice Address - Country:US
Practice Address - Phone:978-459-8400
Practice Address - Fax:978-459-2345
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2011-04-06
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Provider Licenses
StateLicense IDTaxonomies
MA51568207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA68148Medicare UPIN
MAJ04389Medicare ID - Type Unspecified