Provider Demographics
NPI:1740262484
Name:ABRAMSON, JEREMY SLADE (MD)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:SLADE
Last Name:ABRAMSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:55 FRUIT ST
Mailing Address - Street 2:MGH CANCER CENTER, YAWKEY 7B
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2621
Mailing Address - Country:US
Mailing Address - Phone:617-724-4000
Mailing Address - Fax:617-643-1915
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:MGH CANCER CENTER, YAWKEY 7B
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-724-4000
Practice Address - Fax:617-643-1915
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2008-01-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA213888207R00000X
MA217458207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ27193OtherBCBS MA
MA2036355Medicaid
MA469176OtherTUFTS HEALTH PLAN
MAJ27193OtherBCBS MA
I02778Medicare UPIN