Individual
PAUL R TANGUAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
235 N PEARL ST, ATTN PATHOLOGY DEPT, BROCKTON, MA 02301-1794
(508) 427-3086
(508) 588-0520
Mailing address
235 NORTH PEARL ST, DEPT OF PATHOLOGY, BROCKTON, MA 02301-1794
(508) 427-3086
(508) 588-0520
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
40290
MA
207ZC0500X
Cytopathology Physician
40290
MA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
40290
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34295
HPHC
MA
05
—
6177875
—
MA
01
—
725136
TUFTS
MA
01
—
J02611
BCBS
MA
Enumeration date
11/09/2005
Last updated
10/19/2015
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