Provider Demographics
NPI:1902802879
Name:AUGUST, JOSEPH E (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:E
Last Name:AUGUST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 CENTENNIAL DR
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-7901
Mailing Address - Country:US
Mailing Address - Phone:978-531-7677
Mailing Address - Fax:978-531-7690
Practice Address - Street 1:27 CENTENNIAL DR
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-7901
Practice Address - Country:US
Practice Address - Phone:978-531-7677
Practice Address - Fax:978-531-7690
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA80213207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
2074648OtherAETNA (HMO)
MAAA10466OtherHARVARD PILGRIM
4347578OtherCIGNA
MA080213OtherTUFTS
5752146OtherAETNA (PPO)
MAJ31618OtherBCBS
G08971Medicare UPIN
2074648OtherAETNA (HMO)