Provider Demographics
NPI:1942531678
Name:CHARLES R. MORIN, M.D., LLC
Entity Type:Organization
Organization Name:CHARLES R. MORIN, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:MORIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-771-7031
Mailing Address - Street 1:231 CHIEF JUSTICE CUSHING HWY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:COHASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02025-1380
Mailing Address - Country:US
Mailing Address - Phone:781-771-7031
Mailing Address - Fax:866-535-7563
Practice Address - Street 1:231 CHIEF JUSTICE CUSHING HWY
Practice Address - Street 2:SUITE 202
Practice Address - City:COHASSET
Practice Address - State:MA
Practice Address - Zip Code:02025-1380
Practice Address - Country:US
Practice Address - Phone:781-771-7031
Practice Address - Fax:866-535-7563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-20
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA80568261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service