Provider Demographics
NPI:1679753362
Name:PEGG, PAULA ANN (MED)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:ANN
Last Name:PEGG
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 NESTLES LN
Mailing Address - Street 2:
Mailing Address - City:EAST FREETOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02717-1716
Mailing Address - Country:US
Mailing Address - Phone:508-763-5909
Mailing Address - Fax:
Practice Address - Street 1:3 NESTLES LN
Practice Address - Street 2:
Practice Address - City:EAST FREETOWN
Practice Address - State:MA
Practice Address - Zip Code:02717-1716
Practice Address - Country:US
Practice Address - Phone:508-763-5909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator