Provider Demographics
NPI:1669474565
Name:BARON, DAVID E (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:BARON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 FRANKLIN RD
Mailing Address - Street 2:PARKHILL PLAZA
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-5214
Mailing Address - Country:US
Mailing Address - Phone:978-348-1232
Mailing Address - Fax:978-348-2524
Practice Address - Street 1:PARKHILL PLAZA
Practice Address - Street 2:ELECTRIC AVENUE
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420
Practice Address - Country:US
Practice Address - Phone:978-348-1232
Practice Address - Fax:978-348-2524
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3488152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAU356263Medicaid
U18340Medicare UPIN
BAW15835Medicare ID - Type Unspecified