Individual
PHILIP S ELLERIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
172 CAMBRIDGE STREET, SUITE 204, BURLINGTON, MA 01803
(781) 272-7022
(781) 272-8786
Mailing address
172 CAMBRIDGE STREET, SUITE 204, BURLINGTON, MA 01803
(781) 272-7022
(781) 272-8786
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
29481
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03-00053
UNITED HEALTHCARE
MA
01
—
1154420008
MEDICARE - GROUP
MA
01
—
4139
HARVARD PILGRIM HEALTH
MA
01
—
709176
TUFTS HEALTH PLAN
MA
01
—
B27122
BLUE CROSS BLUE SHIELD
MA
01
—
M12131
PTAN
MA
Enumeration date
10/16/2006
Last updated
06/18/2015
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