Individual
CAMILLE D AUDETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
55 LAKE AVE N, 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
Primary
292331
MA
208M00000X
Hospitalist Physician
292331
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110153943A
—
MA
Enumeration date
03/20/2019
Last updated
10/10/2024
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