Basic Information
| Provider Information | |||||||||
| NPI: | 1568560878 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PAINTER | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 475 FRANKLIN ST | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | FRAMINGHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017026264 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5086209200 | ||||||||
| FaxNumber: | 5086206483 | ||||||||
| Practice Location | |||||||||
| Address1: | 475 FRANKLIN ST | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | FRAMINGHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017026264 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5086209200 | ||||||||
| FaxNumber: | 5086206483 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2006 | ||||||||
| LastUpdateDate: | 12/29/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 41114 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0100X | 41114 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 000000026642 | 01 | MA | BMC HEALTHNET PLAN | OTHER | 0004957 | 01 | MA | NEIGHBORHOOD HEALTH PLAN | OTHER | 2070693 | 05 | MA | MEDICAID | 701738 | 01 | MA | TUFTS HEALTH PLAN | OTHER | 30911 | 01 | MA | FALLON HEALTH PLAN | OTHER | AA77689 | 01 | MA | HARVARD PILGRIM HEALTH | OTHER | C18111 | 01 | MA | BC/BS | OTHER | 29-02008 | 01 | MA | UNITED HEALTH CARE | OTHER | 65791 | 01 | MA | CIGNA | OTHER | 0524156 | 01 | MA | AETNA HEALTH PLAN | OTHER | C18111 | 01 | MA | RR MEDICARE | OTHER |