John P. Dorval, PA-C
Physician Assistant in Worcester, MA. Individual provider (NPI-1).
NPI number1164081667
StatusActive
Last updated in NPPESJul 7, 2021
Details
- NPI
- 1164081667
- Entity type
- Individual (NPI-1)
- Name
- John P. Dorval
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 7, 2019
- Certification date
- Jul 7, 2021
- Last updated
- Jul 7, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA7465 | MA | Yes |
Practice location
55 Lake Ave NWorcester, MA 01655-0002
Phone 508-421-1400 · Fax 508-421-1490
Mailing address
12 Pearly LnGardner, MA 01440-1736
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