Provider Demographics
NPI:1255376182
Name:WESTPHAL, ELIZABETH A (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:WESTPHAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:488 BOSTON POST RD E
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-3604
Mailing Address - Country:US
Mailing Address - Phone:508-786-0707
Mailing Address - Fax:508-786-0770
Practice Address - Street 1:488 BOSTON POST RD E
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-3604
Practice Address - Country:US
Practice Address - Phone:508-786-0707
Practice Address - Fax:508-786-0770
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2010-06-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA212934207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0185001Medicaid
MAJ25563OtherBLUE CROSS BLUE SHIELD
MAJ25563OtherBLUE CROSS BLUE SHIELD
H70921Medicare UPIN