Provider Demographics
NPI:1083912018
Name:MARK S. AMSTER MD
Entity Type:Organization
Organization Name:MARK S. AMSTER MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:S
Authorized Official - Last Name:AMSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-721-6552
Mailing Address - Street 1:18 WHISPERING LN
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-5883
Mailing Address - Country:US
Mailing Address - Phone:508-655-2072
Mailing Address - Fax:508-655-6811
Practice Address - Street 1:61 LINCOLN ST
Practice Address - Street 2:SUITE #307
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8264
Practice Address - Country:US
Practice Address - Phone:508-872-1482
Practice Address - Fax:617-783-7104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA70448207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAE35779Medicare UPIN