Provider Demographics
NPI:1134538242
Name:DAMIAN FOLCH MD
Entity type:Organization
Organization Name:DAMIAN FOLCH MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FOLCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-250-9495
Mailing Address - Street 1:35 VILLAGE SQ
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-2712
Mailing Address - Country:US
Mailing Address - Phone:978-250-9495
Mailing Address - Fax:978-250-3979
Practice Address - Street 1:35 VILLAGE SQ
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-2712
Practice Address - Country:US
Practice Address - Phone:978-250-9495
Practice Address - Fax:978-250-3979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-04
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA70456261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3043126Medicaid
MA3043126Medicaid