MEDICARE: DR. MARK BARRY ABELSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	37429	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	M08808	OTHER	MA	BLUECROSS/BLUESHIELD
3	26176	OTHER	MA	FALLON
4	15823	OTHER	MA	HARVARD PILGRIM HEALTHCAR
5	037429	OTHER	MA	TUFTS

General Provider Information

NPI Number	:	1811990682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK BARRY ABELSON M.D.

Provider Business Mailing Address
First Line	:	138 HAVERHILL ST
Second Line	:	STE 104
City	:	ANDOVER
State	:	MA
Zip	:	01810-1501
Country	:	US
Telephone Number	:	978-475-0705
Fax Number	:	978-475-0008

Provider Business Practice Location Address
First Line	:	138 HAVERHILL ST
Second Line	:	STE 104
City	:	ANDOVER
State	:	MA
Zip	:	01810-1501
Country	:	US
Telephone Number	:	978-475-0705
Fax Number	:	978-475-0008

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	11/14/2007

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