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Individual

ELIZABETH JOAN DWYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 856-4161
(508) 856-6703
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA7813
MA
363A00000X
Physician Assistant
363AM0700X
Medical Physician Assistant
0110006146
VA
363AM0700X
Medical Physician Assistant
PA7813
MA

Other

Enumeration date
07/18/2018
Last updated
05/25/2021
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