Individual
MARK A AVERSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
116 BELMONT ST, WORCESTER, MA 01605-2964
(508) 791-4300
(508) 756-8777
Mailing address
116 BELMONT ST, WORCESTER, MA 01605-2964
(508) 791-4300
(508) 756-8777
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
53840
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3005461
—
MA
Enumeration date
01/25/2006
Last updated
04/29/2008
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