Provider Demographics
NPI:1568438513
Name:TREADUP, ANNE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:ANNE MARIE
Middle Name:
Last Name:TREADUP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 MILL RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:500 FAUNCE CORNER RD STE 160
Practice Address - Street 2:
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1277
Practice Address - Country:US
Practice Address - Phone:508-973-1230
Practice Address - Fax:508-973-1245
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA154754207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110060148AMedicaid
MA110060148AMedicaid
G71176Medicare UPIN
MAA28414Medicare PIN
MA710517OtherHARVARD-PILGRIM HEALTHCARE