Provider Demographics
NPI:1659457984
Name:ALLARA, MARK E (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:E
Last Name:ALLARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:147 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01949-2446
Mailing Address - Country:US
Mailing Address - Phone:978-774-2555
Mailing Address - Fax:978-774-8715
Practice Address - Street 1:147 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:MA
Practice Address - Zip Code:01949-2446
Practice Address - Country:US
Practice Address - Phone:978-774-2555
Practice Address - Fax:978-774-8715
Is Sole Proprietor?:No
Enumeration Date:2006-10-30
Last Update Date:2010-02-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA82135207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3172538Medicaid
MA082135OtherTUFTS
MAJ18284OtherBLUE CROSS BLUE SHIELD
G68561Medicare UPIN
MA3172538Medicaid