Basic Information
| Provider Information | |||||||||
| NPI: | 1760470041 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARSAM | ||||||||
| FirstName: | CHARLES | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 170 RUTLEDGE RD | ||||||||
| Address2: | |||||||||
| City: | BELMONT | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024782634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8014039750 | ||||||||
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| Practice Location | |||||||||
| Address1: | 725 CONCORD AVE | ||||||||
| Address2: | SUITE 4100 | ||||||||
| City: | CAMBRIDGE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021381040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6178648822 | ||||||||
| FaxNumber: | 6175475367 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2005 | ||||||||
| LastUpdateDate: | 09/02/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 221205 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207W00000X | 221205 | MA | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.