Provider Demographics
NPI:1912926775
Name:LOBOVITS, ALAN M (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:M
Last Name:LOBOVITS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:24 NEWTON ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01772-1215
Mailing Address - Country:US
Mailing Address - Phone:508-481-5500
Mailing Address - Fax:508-460-3221
Practice Address - Street 1:761 WORCESTER RD
Practice Address - Street 2:4TH FLOOR
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-5224
Practice Address - Country:US
Practice Address - Phone:508-872-1260
Practice Address - Fax:508-879-7913
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA51013208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6165265Medicaid
MAJ01171Medicare ID - Type Unspecified
MA6165265Medicaid