Provider Demographics
NPI:1518918598
Name:PRIMMER, OKSANA (MD)
Entity Type:Individual
Prefix:
First Name:OKSANA
Middle Name:
Last Name:PRIMMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:OKSANA
Other - Middle Name:
Other - Last Name:ROGERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5 NEPONSET ST FL STREET2
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2714
Mailing Address - Country:US
Mailing Address - Phone:508-721-1170
Mailing Address - Fax:508-832-0859
Practice Address - Street 1:385 SOUTHBRIDGE ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-2498
Practice Address - Country:US
Practice Address - Phone:508-721-1170
Practice Address - Fax:508-832-0859
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA220575207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
042472266OtherPRIVATE HEALTHCARE SYSTEM
1667164OtherCIGNA HEALTH PLAN
0407079OtherEVERCARE
784178OtherMVP HEALTH CARE
042472266OtherTHREE RIVERS
419318OtherTUFTS HEALTH PLAN
91200OtherFALLON COMMUNITY HEALTH
042472266OtherUNITED HEALTHCARE
J28269OtherBLUE SHIELD HMO BLUE
MA2080796Medicaid
7339615OtherAETNA US HEALTHCARE
AA16904OtherHARVARD PILGRIM HEALTHCAR
J28269OtherBLUE SHIELD INDEMNITY
J28269OtherBLUE CARE ELECT
A37781Medicare ID - Type UnspecifiedB
MA2080796Medicaid
J28269OtherBLUE CARE ELECT