Provider Demographics
NPI:1316910979
Name:FINKELSTEIN, EVAN DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:EVAN
Middle Name:DAVID
Last Name:FINKELSTEIN
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 1:62 WALPOLE ST
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3316
Mailing Address - Country:US
Mailing Address - Phone:781-769-4090
Mailing Address - Fax:781-769-6485
Practice Address - Street 1:62 WALPOLE ST
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3316
Practice Address - Country:US
Practice Address - Phone:781-769-4090
Practice Address - Fax:781-769-6485
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA216094208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0187721Medicaid
MA0187721Medicaid
MAH75859Medicare UPIN