Healthcare Provider Details

I. General information

NPI: 1013167048
Provider Name (Legal Business Name): ANDREW H SEGAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2008
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 EMERSON PL APT 9H
BOSTON MA
02114-2209
US

IV. Provider business mailing address

7500 LISBURNE RD
PIKESVILLE MD
21208-4521
US

V. Phone/Fax

Practice location:
  • Phone: 617-777-5083
  • Fax: 617-336-3487
Mailing address:
  • Phone: 617-777-5083
  • Fax: 617-336-3487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number234543
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberD0096628
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: