Provider Demographics
NPI:1851367858
Name:RE, PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:RE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:54 BAKER AVENUE EXT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-2137
Mailing Address - Country:US
Mailing Address - Phone:978-369-5391
Mailing Address - Fax:978-369-7661
Practice Address - Street 1:54 BAKER AVENUE EXT
Practice Address - Street 2:SUITE 200
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2137
Practice Address - Country:US
Practice Address - Phone:978-369-5391
Practice Address - Fax:978-369-7661
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2013-06-27
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Provider Licenses
StateLicense IDTaxonomies
MA513223207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA200034530OtherRAILROAD MEDICARE
MA200034530OtherRAILROAD MEDICARE
G42945Medicare UPIN