EDRESS OTHMAN (NPI# 1508916792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508916792 |
| Entity Type | Individual |
| Full Name | EDRESS OTHMAN |
| Credential | MD |
| Practice Address |
206 Mill Rd Fairhaven MA 02719-5208 |
| Mailing Address |
200 Mill Rd Suite 180 Fairhaven MA 02719-5252 |
| Practice Telephone | 5089733000 |
| Practice Fax Number | 5089733119 |
| Mailing Telephone | 5089732000 |
| Mailing Fax Number | 5089732001 |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2020-04-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
254703 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 1508916792 | 05 |
| Street Address |
206 MILL RD |
| City | FAIRHAVEN |
| State | MA |
| Zip Code | 02719-5208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134198989 | Elizabeth M Blanchard | Internal Medicine | 206 Mill Rd, Fairhaven, MA 02719-5208 | 2006-03-15 |
| 1457981151 | Magen Ann Crepeau | Nurse Practitioner | 206 Mill Rd, Fairhaven, MA 02719-5208 | 2020-01-22 |
| 1568876589 | Southcoast Hospitals Group | Pharmacy | 206 Mill Rd, Fairhaven, MA 02719-5208 | 2014-06-18 |
| 1912334186 | Siri Mohr | Nurse Practitioner | 206 Mill Rd, Fairhaven, MA 02719-5208 | 2013-10-03 |
| 1609004969 | Sophia Rizk | Internal Medicine | 206 Mill Rd, Fairhaven, MA 02719-5208 | 2009-06-25 |
| 1467618421 | Roxane Jeanne Fredette | Nurse Practitioner | 206 Mill Rd, Fairhaven, MA 02719-5208 | 2008-07-30 |
| 1437326105 | Jennifer Ann Ducie | Obstetrics & Gynecology | 206 Mill Rd, Fairhaven, MA 02719-5208 | 2008-05-13 |
| 1770765505 | Suzelle S. Luc | Internal Medicine | 206 Mill Rd, Fairhaven, MA 02719-5208 | 2007-12-04 |
| 1891985990 | Susan J Kim | Internal Medicine | 206 Mill Rd, Fairhaven, MA 02719-5208 | 2007-07-26 |
| 1588869366 | Patrick James Gagnon | Radiology | 206 Mill Rd, Fairhaven, MA 02719-5208 | 2007-06-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457589772 | David Paul Patterson | Nurse Practitioner | 271 Alden Rd, Fairhaven, MA 02719 | 2009-06-25 |
| 1245415983 | Carol Ann Reeve | Social Worker | 21 Nelson Ave, Fairhaven, MA 02719 | 2007-12-31 |
| 1194842716 | Cathleen Lacy | Physical Therapist | 333 Bridge St, Fairhaven, MA 02719 | 2007-03-26 |
| 1700903978 | Barbara Ann Acksen | Psychologist | 91 Green Street, Fairhaven, MA 02719 | 2007-03-23 |
| 1811023260 | Merolla Chiropractic Inc | Chiropractor | 73 Alden Rd, Fairhaven, MA 02719 | 2007-02-27 |
| 1982746442 | Michele E Merolla | Chiropractor | 73 Aiden Rd, Fairhaven, MA 02719 | 2007-02-13 |
| 1417016338 | Brian K Bowcock | Chiropractor | 84 Huttleston Avenue, Fairhaven, MA 02719 | 2006-12-06 |
| 1104937697 | Southcoast Visiting Nurse Association. Inc | Home Health | 200 Mill Road, Suite 120, Fairhaven, MA 02719 | 2006-08-31 |
| 1902817299 | 184 Main LLC | Skilled Nursing Facility | 184 Main Street, Fairhaven, MA 02719 | 2006-08-11 |
| 1821584103 | Smiley Dental Care Pllc | Clinic/Center | 17 Berdon Way, Fairheaven, MA 02719 | 2018-07-10 |
| Find all providers in zip 02719 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134198989 | Elizabeth M Blanchard | Internal Medicine | 206 Mill Rd, Fairhaven, MA 02719-5208 | 2006-03-15 |
| 1609004969 | Sophia Rizk | Internal Medicine | 206 Mill Rd, Fairhaven, MA 02719-5208 | 2009-06-25 |
| 1891985990 | Susan J Kim | Internal Medicine | 206 Mill Rd, Fairhaven, MA 02719-5208 | 2007-07-26 |
| 1699737874 | Harry W Matelski | Internal Medicine | 206 Mill Rd, Fairhaven, MA 02719-5208 | 2006-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699305615 | Donghui L Yu | Internal Medicine | 1500 District Ave Ste 2119, Burlington, MA 01803-5069 | 2020-01-17 |
| 1689191090 | Clinton Wayne Lewis | Internal Medicine | 450 Brookline Ave # 2-058, Boston, MA 02215-5418 | 2017-08-25 |
| 1306208905 | Gregory Ivan Berk | Internal Medicine | 133 Claybrook Rd, Dover, MA 02030-2116 | 2016-03-23 |
| 1457732711 | Camille Johnson | Internal Medicine | Section of Hematology and Oncology Bu/bmc Cancer Center, Boston University 650 Albany St, Ebrc 406, Boston, MA 02118 | 2015-06-12 |
| 1073946018 | Howard George Goldsweig | Internal Medicine | 2400 Beacon St Unit 213, Chestnut Hill, MA 02467-1469 | 2013-08-13 |
| 1861745796 | Benjamin Koziner | Internal Medicine | 11 Farmington Ave, Haverhill, MA 01832-8608 | 2012-10-16 |
| 1962768812 | Elizabeth Paige Walsh | Internal Medicine | 2443 Massachusetts Ave, Apt 3, Cambridge, MA 02140-1132 | 2012-04-04 |
| 1457669293 | Plymouth Medal Group Inc | Internal Medicine | 71 Commercial St, Ste 307, Boston, MA 02109-1320 | 2010-09-14 |
| 1295060812 | Abraham Mark Colb | Internal Medicine | 226 Wren St, West Roxbury, MA 02132-2716 | 2009-10-15 |
| 1962646307 | Anna Berkenblit | Internal Medicine | 35 Cambridge Park Dr., Cambridge, MA 02140 | 2009-04-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.