Provider Demographics
NPI:1972671758
Name:HARRINGTON, PAUL D (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:D
Last Name:HARRINGTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 SOUTHBRIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:CHARLTON
Mailing Address - State:MA
Mailing Address - Zip Code:01507-5237
Mailing Address - Country:US
Mailing Address - Phone:508-248-7849
Mailing Address - Fax:508-248-6541
Practice Address - Street 1:246 SOUTHBRIDGE ROAD
Practice Address - Street 2:
Practice Address - City:CHARLTON
Practice Address - State:MA
Practice Address - Zip Code:01507-5237
Practice Address - Country:US
Practice Address - Phone:508-248-7849
Practice Address - Fax:508-248-6541
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA49523207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0163503Medicaid
MAE10005Medicare ID - Type Unspecified
MA0163503Medicaid