Provider Demographics
NPI:1598877144
Name:OAK STREET MEDICAL ASSOCIATES,PC
Entity Type:Organization
Organization Name:OAK STREET MEDICAL ASSOCIATES,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EARL
Authorized Official - Middle Name:L
Authorized Official - Last Name:YUNES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-455-6200
Mailing Address - Street 1:300 CHESTNUT ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-2427
Mailing Address - Country:US
Mailing Address - Phone:781-455-6200
Mailing Address - Fax:781-449-1096
Practice Address - Street 1:300 CHESTNUT ST
Practice Address - Street 2:SUITE 700
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2427
Practice Address - Country:US
Practice Address - Phone:781-455-6200
Practice Address - Fax:781-449-1096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA35581207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAC16101OtherBLUE CROSS BLUE SHIELD
MAC16101OtherBLUE CROSS BLUE SHIELD
MAM15725Medicare ID - Type UnspecifiedGROUP NUMBER
MAC16101Medicare PIN