Provider Demographics
NPI:1821449588
Name:ADDINGTON, STEPHEN R (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:R
Last Name:ADDINGTON
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Gender:
Credentials:MD
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Mailing Address - Street 1:960 MASSACHUSETTS AVENUE
Mailing Address - Street 2:FL 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2690
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1350 BELMONT ST
Practice Address - Street 2:SUITE 102
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301
Practice Address - Country:US
Practice Address - Phone:774-776-2991
Practice Address - Fax:508-584-4105
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2025-03-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA268685208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110150197AMedicaid