MEDICARE: DR. RICHARD W. ASHBURN MD

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	207R00000X	Internal Medicine Physician	77246	MA
2	207RP1001X	Pulmonary Disease Physician	77246	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	48985	OTHER	MA	FALLON COMMUNITY HEALTH
2	0036414	OTHER	MA	NEIGHBORHOOD HEALTH PLAN
3	077246	OTHER	MA	TUFTS HEALTH PLAN
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	66289	OTHER	MA	HARVARD PILGRIM
6	J14114	OTHER	MA	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1861492746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD W. ASHBURN MD

Provider Business Mailing Address
First Line	:	541 MAIN ST
Second Line	:	SUITE 314
City	:	SOUTH WEYMOUTH
State	:	MA
Zip	:	02190-1868
Country	:	US
Telephone Number	:	781-952-1480
Fax Number	:	781-340-1610

Provider Business Practice Location Address
First Line	:	541 MAIN ST
Second Line	:	SUITE 400
City	:	SOUTH WEYMOUTH
State	:	MA
Zip	:	02190-1868
Country	:	US
Telephone Number	:	781-952-1200
Fax Number	:	781-340-1610

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

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	02/23/2016

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