Provider Demographics
NPI:1740369685
Name:BIELAWSKI, MARTIN A (MD)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:A
Last Name:BIELAWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:463 WORCESTER RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-5356
Mailing Address - Country:US
Mailing Address - Phone:508-879-0888
Mailing Address - Fax:508-626-1985
Practice Address - Street 1:463 WORCESTER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-5356
Practice Address - Country:US
Practice Address - Phone:508-879-0888
Practice Address - Fax:508-626-1985
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA384152084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA20256OtherFALLON
MA2061139Medicaid
MA00199OtherNEIGHBORHOOD HEALTH PLAN
MA48747OtherAETNA/US HEALTHCARE
MD038415OtherTUFTS HEALTH PLAN
MA2000000018OtherHARVARD PILGRIM HEALTH PL
MA130010185OtherRAILROAD RETIREMENT MEDIC
MAA66851Medicare UPIN
MA2061139Medicaid