Provider Demographics
NPI:1811990682
Name:ABELSON, MARK BARRY (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:BARRY
Last Name:ABELSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:138 HAVERHILL ST
Mailing Address - Street 2:STE 104
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-1501
Mailing Address - Country:US
Mailing Address - Phone:978-475-0705
Mailing Address - Fax:978-475-0008
Practice Address - Street 1:138 HAVERHILL ST
Practice Address - Street 2:STE 104
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-1501
Practice Address - Country:US
Practice Address - Phone:978-475-0705
Practice Address - Fax:978-475-0008
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2007-11-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA37429207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2035618Medicaid
MAM08808OtherBLUECROSS/BLUESHIELD
MA26176OtherFALLON
MA15823OtherHARVARD PILGRIM HEALTHCAR
MA037429OtherTUFTS
MAM08808OtherBLUECROSS/BLUESHIELD
A66751Medicare UPIN