Individual
PAUL L. WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
40 WRIGHT ST, PALMER, MA 01069-1138
(413) 283-7651
Mailing address
8 WHITAKER LN, GROTON, MA 01450-1986
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
151956
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110058602A
—
MA
Enumeration date
10/25/2005
Last updated
09/02/2021
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