Provider Demographics
NPI:1295703932
Name:SEWARD, SUSAN J (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:J
Last Name:SEWARD
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Gender:F
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:617-726-8157
Mailing Address - Fax:617-724-7799
Practice Address - Street 1:15 PARKMAN ST WAC 635
Practice Address - Street 2:INTERNAL MEDICINE ASSOCIATES TEAM 3
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-726-8157
Practice Address - Fax:617-724-7799
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2012-12-27
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Provider Licenses
StateLicense IDTaxonomies
MA57080207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3067475Medicaid
MAJ10464OtherBCBS MA
MA724158OtherTUFTS HEALTH PLAN
MAJ10464OtherBCBS MA
MAJ10464Medicare ID - Type Unspecified