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Individual

MATTHEW DEFAZIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
281 LINCOLN ST, WORCESTER, MA 01605-2138
(508) 334-5916
(508) 793-6326
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
1022482
MA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/31/2020
Last updated
10/07/2025
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