Individual
PAUL M LAROCQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1900 RANDOLPH RD, STE 900, CHARLOTTE, NC 28207-1122
(704) 377-2424
(704) 377-2687
Mailing address
1290 SILAS DEANE HWY, HHC CVO ENROLLMENT 1ST FLOOR, WETHERSFIELD, CT 06109-4337
(860) 972-6970
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
00181
CT
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00181
CT LIC
CT
Enumeration date
07/23/2006
Last updated
08/28/2020
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