Provider Demographics
NPI:1780627505
Name:PACE, MEREDITH MATTISON (MD)
Entity type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:MATTISON
Last Name:PACE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MEREDITH
Other - Middle Name:EDWARDS
Other - Last Name:MATTISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:80 DAVISON DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:MA
Mailing Address - Zip Code:01773-2216
Mailing Address - Country:US
Mailing Address - Phone:802-299-5062
Mailing Address - Fax:
Practice Address - Street 1:LAHEY HOSPITAL & MEDICAL CTR
Practice Address - Street 2:41 MALL RD.
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01805-0001
Practice Address - Country:US
Practice Address - Phone:781-744-8132
Practice Address - Fax:781-744-2273
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA253937207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine