Provider Demographics
NPI:1861492746
Name:ASHBURN, RICHARD W (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:W
Last Name:ASHBURN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:541 MAIN ST
Mailing Address - Street 2:SUITE 314
Mailing Address - City:SOUTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1868
Mailing Address - Country:US
Mailing Address - Phone:781-952-1480
Mailing Address - Fax:781-340-1610
Practice Address - Street 1:541 MAIN ST
Practice Address - Street 2:SUITE 400
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1868
Practice Address - Country:US
Practice Address - Phone:781-952-1200
Practice Address - Fax:781-340-1610
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2016-02-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA77246207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA48985OtherFALLON COMMUNITY HEALTH
MA0036414OtherNEIGHBORHOOD HEALTH PLAN
MA077246OtherTUFTS HEALTH PLAN
MA3126064Medicaid
MA66289OtherHARVARD PILGRIM
MAJ14114OtherBLUE CROSS BLUE SHIELD
MAJ14114Medicare PIN
MA0036414OtherNEIGHBORHOOD HEALTH PLAN