Provider Demographics
NPI:1841267390
Name:DUCLOS, ABBY A (MD)
Entity type:Individual
Prefix:DR
First Name:ABBY
Middle Name:A
Last Name:DUCLOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:323 LOWELL ST STE 302
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-4501
Mailing Address - Country:US
Mailing Address - Phone:978-475-2731
Mailing Address - Fax:978-975-2536
Practice Address - Street 1:323 LOWELL ST STE 302
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-4501
Practice Address - Country:US
Practice Address - Phone:978-475-2731
Practice Address - Fax:978-975-2536
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA273735207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006211445Medicaid
VA006211445Medicaid
VAP00322646Medicare PIN
VA1841267390Medicaid
VA160001536Medicare PIN
VAVV7928AMedicare PIN