Provider Demographics
NPI:1568560878
Name:PAINTER, MARK A (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:PAINTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 FRANKLIN ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-6264
Mailing Address - Country:US
Mailing Address - Phone:508-620-9200
Mailing Address - Fax:508-620-6483
Practice Address - Street 1:475 FRANKLIN ST
Practice Address - Street 2:SUITE 110
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6264
Practice Address - Country:US
Practice Address - Phone:508-620-9200
Practice Address - Fax:508-620-6483
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA41114207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000026642OtherBMC HEALTHNET PLAN
MA0004957OtherNEIGHBORHOOD HEALTH PLAN
MA2070693Medicaid
MA701738OtherTUFTS HEALTH PLAN
MA30911OtherFALLON HEALTH PLAN
MAAA77689OtherHARVARD PILGRIM HEALTH
MAC18111OtherBC/BS
MA29-02008OtherUNITED HEALTH CARE
MA65791OtherCIGNA
MA0524156OtherAETNA HEALTH PLAN
MAC18111OtherRR MEDICARE
MAA53792Medicare UPIN
MA0004957OtherNEIGHBORHOOD HEALTH PLAN