Provider Demographics
NPI:1861481301
Name:ST PIERRE, DAVID P (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:P
Last Name:ST PIERRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:58 RIVER ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-3378
Mailing Address - Country:US
Mailing Address - Phone:978-618-9231
Mailing Address - Fax:978-774-5883
Practice Address - Street 1:4 STATE RD
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-2567
Practice Address - Country:US
Practice Address - Phone:978-774-3400
Practice Address - Fax:978-774-5883
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA46461207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA046461OtherTUFTS
MA17223OtherHPHC
MA2084777OtherAETNA
MA3135608Medicaid
MA0022664OtherNEIGHBORHOOD HEALTH PLAN
MAD05069OtherBCBS
V40876OtherNETWORK HEALTH
MA2451201OtherUNITEDHEALTHCARE
MA046461OtherTUFTS
MA2451201OtherUNITEDHEALTHCARE
MAD05069Medicare PIN