Individual
RICHARD S PIETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(774) 442-5551
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
55621
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
055621
CONNECTICARE OF MASSACHUSETTS
MA
05
—
110043087A
—
MA
01
—
4321987
AETNA
FL
01
—
97554203
NETWORK HEALTH
MA
01
—
J0562201
MEDICARE SECONDARY SITE
MA
01
—
P00452743
RR MEDICARE FOR PRIMARY SITE
MA
01
—
P00762762
RR MEDICAR FOR 2ND SITE
MA
01
—
P01754062
RR MEDICARE
FL
Enumeration date
11/20/2005
Last updated
11/20/2020
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