Provider Demographics
NPI:1144287236
Name:RASMUSSEN, IRMA EUGENIA (MD)
Entity type:Individual
Prefix:
First Name:IRMA
Middle Name:EUGENIA
Last Name:RASMUSSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:IRMA
Other - Middle Name:EUGENIA
Other - Last Name:BERRIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 WAVERLY ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-7033
Mailing Address - Country:US
Mailing Address - Phone:508-872-0904
Mailing Address - Fax:
Practice Address - Street 1:400 WAVERLY ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-7033
Practice Address - Country:US
Practice Address - Phone:508-872-0904
Practice Address - Fax:508-872-0906
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230841207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H98332Medicare UPIN
007056009Medicare ID - Type Unspecified