Dr. Theodore Eric Macnow, MD
Pediatrics, Pediatric Emergency Medicine in Worcester, MA. Individual provider (NPI-1).
NPI number1760626832
StatusActive
Last updated in NPPESNov 9, 2020
Details
- NPI
- 1760626832
- Entity type
- Individual (NPI-1)
- Name
- Dr. Theodore Eric Macnow
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 20, 2009
- Certification date
- Nov 9, 2020
- Last updated
- Nov 9, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080P0204X | Pediatrics, Pediatric Emergency Medicine | 254522 | MA | Yes |
| 208000000X | Pediatrics | 254522 | MA |
Practice location
55 Lake Ave NEmergency Medicine Department
Worcester, MA 01655-0002
Phone 774-442-2599 · Fax 774-442-2510
Mailing address
Po Box 415348Boston, MA 02241-5348
Phone 800-225-8885 · Fax 508-334-1977
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