Provider Demographics
NPI:1841398161
Name:AWBREY, BRIAN J (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:J
Last Name:AWBREY
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 1:151 MERRIMAC ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-4714
Mailing Address - Country:US
Mailing Address - Phone:617-726-3808
Mailing Address - Fax:617-726-4812
Practice Address - Street 1:151 MERRIMAC ST
Practice Address - Street 2:SUITE 202
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-4714
Practice Address - Country:US
Practice Address - Phone:617-726-3808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA54010207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30005103Medicaid
MA6192491Medicaid
MAJ04176OtherBCBS - INDIVIDUAL
MA710141OtherTUFTS OUT-OF-NETWORK
MAA57196Medicare UPIN
MA6192491Medicaid