Individual
DAVID P LYONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, ACC BUILDING DEPT OF CARDIOLOGY, WORCESTER, MA 01655-0002
(774) 443-3707
Mailing address
PO BOX 415348, BOSTON, MA 02241-5438
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
54038
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043444640
TAX ID
MA
05
—
110065874A
—
MA
Enumeration date
12/28/2005
Last updated
11/10/2020
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