Eisenberg, Mark Philip
Eisenberg, Mark Philip is an individual health care provider with primary practice located at 15 Fruit St Mgh, Fruit St MA 02114-3026. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Infectious Disease, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Eisenberg, Mark Philip can be contacted via phone (617) 724-8135.Contact Information
Primary practice address
15 Fruit St Mgh
Fruit St MA 02114-3026
Phone: (617) 724-8135
Fax: (617) 724-8010
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207RA0401X | 54761 | Massachusetts |
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | 54761 | Massachusetts |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 54761 | Massachusetts |
Profile Details
| NPI number | 1487628418 |
|---|---|
| LBN Legal business name | Eisenberg, Mark Philip |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 15th, 2006 |
| Last updated | Sep 23rd, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487628418 | NPPES |
| Massachusetts | Other | 054761 | TUFTS HEALTH PLAN |
| Massachusetts | MEDICAID | 3013103 | TUFTS HEALTH PLAN |
| Massachusetts | Other | J05654 | TUFTS HEALTH PLAN |
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