Provider Demographics
NPI:1760557680
Name:SOLOMON, ALAN (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:SOLOMON
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 1:116 MECHANIC ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:BELLINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02019-1678
Mailing Address - Country:US
Mailing Address - Phone:508-966-9888
Mailing Address - Fax:508-966-9088
Practice Address - Street 1:116 MECHANIC ST
Practice Address - Street 2:UNIT 1
Practice Address - City:BELLINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02019-1678
Practice Address - Country:US
Practice Address - Phone:508-966-9888
Practice Address - Fax:508-966-9088
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA029414207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0183083Medicaid
MA0183083Medicaid
MA73231Medicare UPIN