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General NPI Number Information
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NPI Number | 1760470041
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Entity Type | Individual
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Provider Name | CHARLES A. BARSAM M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/11/2005
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Last Update Date | 09/02/2020
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Provider Practice Location Address
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Address Line | 725 CONCORD AVE SUITE 4100
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City | CAMBRIDGE
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State | MA
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Zip | 02138-1040
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Country | US
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Telephone | 617-864-8822
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Fax | 617-547-5367
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Provider Business Mailing Address
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Address Line | 170 RUTLEDGE RD
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City | BELMONT
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State | MA
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Zip | 02478-2634
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Country | US
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Telephone | 801-403-9750
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 221205
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 221205
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License Number State | MA
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