Provider Demographics
NPI:1265420442
Name:BOND, ANDREA J (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:J
Last Name:BOND
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:200 MILL RD
Mailing Address - Street 2:STE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:2444 E MAIN RD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:RI
Practice Address - Zip Code:02871-4025
Practice Address - Country:US
Practice Address - Phone:401-683-4817
Practice Address - Fax:508-973-0318
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2024-10-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
RIMD09062207Q00000X
MA152833207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7005263Medicaid
RI0890203371Medicare PIN
G23787Medicare UPIN