Provider Demographics
NPI:1356306211
Name:WARSHAW, JAMES A (MD, PHD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:WARSHAW
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 BAY ST
Mailing Address - Street 2:SUITE 204B
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-1085
Mailing Address - Country:US
Mailing Address - Phone:508-821-9400
Mailing Address - Fax:508-821-9151
Practice Address - Street 1:2005 BAY ST
Practice Address - Street 2:SUITE 204B
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-1085
Practice Address - Country:US
Practice Address - Phone:508-821-9400
Practice Address - Fax:508-821-9151
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA79137207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3160378Medicaid
MAJ14855Medicare ID - Type Unspecified
MA3160378Medicaid