Individual
DR. MICHAEL ROBERT THEERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
46 CENTRAL ST, WEST BOYLSTON, MA 01583-1653
(508) 835-3934
(508) 835-3934
Mailing address
201 SALISBURY ST, WORCESTER, MA 01609-1640
(508) 755-7830
(508) 754-2987
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
38111
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0180629
—
MA
01
—
23518
CIGNA
MA
01
—
4977
FALLON HEALTH PLAN
MA
01
—
64765
HARVARD-PILGRIM HEALTHCAR
MA
01
—
712458
TUFTS
MA
01
—
E21017
BLUE CROSS
MA
Enumeration date
02/13/2006
Last updated
07/05/2012
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