Provider Demographics
NPI:1912998501
Name:ALFRED, PIERRE R (MD)
Entity Type:Individual
Prefix:DR
First Name:PIERRE
Middle Name:R
Last Name:ALFRED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:184 MARKET DR
Mailing Address - Street 2:
Mailing Address - City:ATHOL
Mailing Address - State:MA
Mailing Address - Zip Code:01331-9829
Mailing Address - Country:US
Mailing Address - Phone:978-939-3128
Mailing Address - Fax:978-650-2090
Practice Address - Street 1:184 MARKET DR
Practice Address - Street 2:
Practice Address - City:ATHOL
Practice Address - State:MA
Practice Address - Zip Code:01331-9829
Practice Address - Country:US
Practice Address - Phone:978-939-3128
Practice Address - Fax:978-650-2090
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA155979207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3173046Medicaid
MA3173046Medicaid
MAMA0318750AROtherDEA STATE
MAMA0318750AROtherDEA STATE
MAA23165Medicare ID - Type Unspecified