Individual
DR. THEODORE ERIC MACNOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 LAKE AVE N, EMERGENCY MEDICINE DEPARTMENT, WORCESTER, MA 01655-0002
(774) 442-2599
(774) 442-2510
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
254522
MA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
254522
MA
Other
Enumeration date
04/20/2009
Last updated
11/09/2020
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