Provider Demographics
NPI:1053347229
Name:BARRETT, SUSAN E (MD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:BARRETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-0189
Mailing Address - Country:US
Mailing Address - Phone:508-478-7135
Mailing Address - Fax:508-473-7198
Practice Address - Street 1:321 FORTUNE BLVD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-1750
Practice Address - Country:US
Practice Address - Phone:508-478-7135
Practice Address - Fax:508-473-7198
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA216656207X00000X, 207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Not Answered207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2005336Medicaid
MA9607886OtherCIGNA HEALTHCARE
MA92155OtherFALLON
MA216656OtherTUFTS HEALTH PLAN
MA0029355OtherNEIGHBORHOOD HEALTH PLAN
MAAA12255OtherHARVARD PILGRIM HEALTHCAR
MAAETNAOther3628219
MAJ25925OtherBLUE CROSS BLUE SHIELD
MA2005336Medicaid
MAH84789Medicare UPIN