Provider Demographics
NPI:1851381123
Name:ASERKOFF, BERNARD RALPH (MD)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:RALPH
Last Name:ASERKOFF
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-5995
Mailing Address - Fax:617-724-5996
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:BLK 465C GASTROENTEROLOGY ASSOCIATES
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-724-5995
Practice Address - Fax:617-724-5996
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2014-01-31
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Provider Licenses
StateLicense IDTaxonomies
MA31549207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0102784Medicaid
MAM07789OtherBCBS MA
MA707229OtherTUFTS HEALTH PLAN
MA707229OtherTUFTS HEALTH PLAN
MA0102784Medicaid