Provider Demographics
NPI:1679539506
Name:BLEILER, JAMES (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:BLEILER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 BRAMBLEBUSH PARK
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-2325
Mailing Address - Country:US
Mailing Address - Phone:508-540-7555
Mailing Address - Fax:508-540-3008
Practice Address - Street 1:19 BRAMBLE BUSH DR
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2325
Practice Address - Country:US
Practice Address - Phone:508-540-7555
Practice Address - Fax:508-540-3008
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA216261208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ25737OtherBLUE CROSS
MA273323OtherHARVARD PILGRIM
MA2033836Medicaid
MA216261OtherTUFTS HEALTH
MAA34984Medicare ID - Type Unspecified
MAJ25737OtherBLUE CROSS