Provider Demographics
NPI:1437103181
Name:WARNER, BETH M (DO)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:M
Last Name:WARNER
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:421 N MAIN ST
Mailing Address - Street 2:DEPARTMENT OF VETERANS AFFAIRS, PRIMARY CARE CLINIC
Mailing Address - City:LEEDS
Mailing Address - State:MA
Mailing Address - Zip Code:01053-9764
Mailing Address - Country:US
Mailing Address - Phone:413-584-4040
Mailing Address - Fax:413-582-3185
Practice Address - Street 1:421 N MAIN ST
Practice Address - Street 2:DEPARTMENT OF VETERANS AFFAIRS, PRIMARY CARE CLINIC
Practice Address - City:LEEDS
Practice Address - State:MA
Practice Address - Zip Code:01053-9764
Practice Address - Country:US
Practice Address - Phone:413-584-4040
Practice Address - Fax:413-582-3185
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2023-05-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA224042207R00000X, 207RG0300X, 207RH0002X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA55232OtherHARVARD PILGRIM HEALTH CA
ME1102245OtherCIGNA HEALTHCARE
MA2115689Medicaid
MA1212783OtherAETNA HEALTHCARE
MA000000032592OtherBMC HEALTHNET
MAJ29342OtherBCBS OF MASS
MA462292OtherTUFTS HEALTH PLAN
MA024042OtherCONNECTICARE
MA36861OtherHEALTH NEW ENGLAND
MA024042OtherCONNECTICARE
MAAA55232OtherHARVARD PILGRIM HEALTH CA
MAI42790Medicare UPIN