Healthcare Provider Details

I. General information

NPI: 1447711916
Provider Name (Legal Business Name): ALISON M ASIRWATHAM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALISON EDWARDS MD

II. Dates (important events)

Enumeration Date: 03/27/2019
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 BELMONT ST
WORCESTER MA
01605-2903
US

IV. Provider business mailing address

PO BOX 415348
BOSTON MA
02241-5348
US

V. Phone/Fax

Practice location:
  • Phone: 508-334-0550
  • Fax:
Mailing address:
  • Phone: 800-225-8885
  • Fax: 508-334-1977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number1020162
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number1020162
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: