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Organization

STEPHEN J POOR III MDPC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEPHEN JOSEPH POOR III M.D. (PRESIDENT)
(978) 250-8001
Entity
Organization

Contact information

Practice address
17 VILLAGE SQ, CHELMSFORD, MA 01824-2712
(978) 250-8001
(978) 250-4142
Mailing address
1 EDWARD ST, CANTON, MA 02021-2303
(781) 828-3533
(781) 828-2471

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
31356
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9724583
MA
01
M13035
BLUE CROSS & BLUE SHIELD
MA
Enumeration date
05/24/2006
Last updated
08/22/2020
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