Individual
MR. PAUL S MACKINNON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
55 LAKE AVE N, DEPARTMENT OF EMERGENCY MEDICINE, WORCESTER, MA 01655-0002
(508) 856-5256
Mailing address
PO BOX 62, TURNPIKE STATION, SHREWSBURY, MA 01545-0062
(508) 334-8815
(508) 334-5374
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
187538
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0391671
—
MA
Enumeration date
03/31/2006
Last updated
07/08/2007
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