Provider Demographics
NPI:1033492269
Name:STEVEN HERSON MD
Entity Type:Organization
Organization Name:STEVEN HERSON MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-371-2272
Mailing Address - Street 1:131 OLD ROAD TO 9 ACRE COR
Mailing Address - Street 2:JOHN CUMING BUILDING SUITE 650
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-4181
Mailing Address - Country:US
Mailing Address - Phone:978-371-2272
Mailing Address - Fax:978-371-7568
Practice Address - Street 1:131 OLD ROAD TO 9 ACRE COR
Practice Address - Street 2:JOHN CUMING BUILDING SUITE 650
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-4181
Practice Address - Country:US
Practice Address - Phone:978-371-2272
Practice Address - Fax:978-371-7568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA40582207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty