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Individual

SAMUEL JOSEPH ANDONIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
16 CLARKE ST, LEXINGTON, MA 02421-4948
(781) 862-3218
(781) 862-0805
Mailing address
16 CLARKE ST, LEXINGTON, MA 02421-4948
(781) 862-3218
(781) 862-0805

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
37648
MA
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
37648
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
037648
TUFTS
MA
05
2025698
MA
01
D28132
BSBS 20465 MASS
MA
Enumeration date
07/16/2006
Last updated
09/11/2025
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