Provider Demographics
NPI:1831114149
Name:FINKLESTEIN, MARK L (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:L
Last Name:FINKLESTEIN
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 1:189 QUINCY ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02302-2926
Mailing Address - Country:US
Mailing Address - Phone:508-588-6700
Mailing Address - Fax:508-584-3010
Practice Address - Street 1:189 QUINCY ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-2926
Practice Address - Country:US
Practice Address - Phone:508-588-6700
Practice Address - Fax:508-584-3010
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA44548207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6166849Medicaid
MA6166849Medicaid
MAB10027Medicare Oscar/Certification