Provider Demographics
NPI:1740280643
Name:BARR, CONNIE S (MD)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:S
Last Name:BARR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 9120
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02027-9120
Mailing Address - Country:US
Mailing Address - Phone:781-329-1400
Mailing Address - Fax:781-326-0221
Practice Address - Street 1:1 LYONS ST
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-5599
Practice Address - Country:US
Practice Address - Phone:781-329-1400
Practice Address - Fax:781-278-5667
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA44182207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C07121OtherBCBS OF MA
0590102OtherCIGNA
B76406OtherFIRST SENIORITY
C07121OtherBLUE SHIELD INDEMNITY
27391OtherCHILDREN'S MEDICAL SECURI
62045OtherHARVARD PILGRIM PPO
760141OtherTUFTS COMMONWEALTH
110117519OtherRAILROAD MEDICARE
62045OtherHARVARD/PILGRIM
62045OtherHARVARD PILGRIM POS
760141OtherTUFTS
760141OtherTUFTS BENEFIT ADMIN
760141OtherTUFTS TOTAL HEALTH PLAN
C07121OtherBS-BLUE CARE ELECT
0107816OtherMASS HEALTH
0590102OtherHEALTHSOURCE-MA
C07121OtherHMO BLUE/BLUE CHOICE
0016041OtherNEIGHBORHOOD HEALTH PLAN
62045OtherHARVARD/PILGRIM
B76406Medicare UPIN