Provider Demographics
NPI:1083882989
Name:BLEICH, LAUREN MICHELE (MD/MPH)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:MICHELE
Last Name:BLEICH
Suffix:
Gender:F
Credentials:MD/MPH
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:MICHELE
Other - Last Name:BLEICH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:45B DISCOVERY WAY
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-4482
Mailing Address - Country:US
Mailing Address - Phone:978-429-2010
Mailing Address - Fax:978-264-1935
Practice Address - Street 1:45B DISCOVERY WAY
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-4482
Practice Address - Country:US
Practice Address - Phone:978-429-2010
Practice Address - Fax:978-264-1935
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH16572207RG0100X
MA242931207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110086133AMedicaid
MA110086133AMedicaid