Organization
ROBERT DETERS, MD, INTERVENTIONAL PAIN MANAGEMENT
Active
Parent organization
COORDINATED PRIMARY CARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
COORDINATED PRIMARY CARE
Authorized official
PHYLLIS FABELLO (EXECUTIVE DIRECTOR)
(978) 466-4243
Entity
Organization
Contact information
Practice address
50 MEMORIAL DR, SUITE 207, LEOMINSTER, MA 01453-2238
(978) 466-2121
(978) 466-2274
Mailing address
50 MEMORIAL DR, SUITE 207, LEOMINSTER, MA 01453-2238
(978) 466-2121
(978) 466-2274
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9771476
—
MA
Enumeration date
12/01/2008
Last updated
12/01/2008
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