Provider Demographics
NPI:1730131244
Name:XAVIER, ALFREDO F (MD)
Entity type:Individual
Prefix:
First Name:ALFREDO
Middle Name:F
Last Name:XAVIER
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 1:7 CHANNING RD
Mailing Address - Street 2:
Mailing Address - City:MATTAPOISETT
Mailing Address - State:MA
Mailing Address - Zip Code:02739-2105
Mailing Address - Country:US
Mailing Address - Phone:508-978-8798
Mailing Address - Fax:508-994-9628
Practice Address - Street 1:2527 CRANBERRY HWY
Practice Address - Street 2:
Practice Address - City:WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02571-1046
Practice Address - Country:US
Practice Address - Phone:800-841-5200
Practice Address - Fax:508-273-1241
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA048168208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0148237Medicaid
MA0148237Medicaid
A66692Medicare UPIN