Individual
JUAN P. VERNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
123 SUMMER ST, WORCESTER, MA 01608-1216
(508) 363-6025
Mailing address
8 HURTEAU RD, MILLVILLE, MA 01529-1780
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
227758
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110075221A
—
MA
Enumeration date
05/30/2006
Last updated
05/20/2021
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