Basic Information
| Provider Information | |||||||||
| NPI: | 1396960977 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARBOSA | ||||||||
| FirstName: | ANNA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 143 LONGWATER DR | ||||||||
| Address2: | SOUTH SHORE MEDICAL CENTER, INC. | ||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020611683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818785200 | ||||||||
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| Practice Location | |||||||||
| Address1: | 143 LONGWATER DR | ||||||||
| Address2: | SOUTH SHORE MEDICAL CENTER, INC. | ||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020611683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818785200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2007 | ||||||||
| LastUpdateDate: | 03/17/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 235728 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 042297845 | 01 | MA | TRICARE | OTHER | 497703 | 01 | MA | TUFTS HEALTH PLAN | OTHER | 042297845 | 01 | MA | UNICARE | OTHER | 1396960977 | 05 | MA | MEDICAID | AA121941 | 01 | MA | HARVARD PILGRIM | OTHER | 1396960977 | 01 | MA | FALLON HEALTH CARE | OTHER | 7628174 | 01 | MA | CIGNA HEALTH CARE | OTHER | J43672 | 01 | MA | BCBSMA | OTHER | 04-2297845 | 01 | UNITED HEALTH CARE | OTHER | 042297845 | 01 | MULTI-PLAN | OTHER | 497703 | 01 | MA | TUFTS MEDICARE PREFERRED | OTHER |