Provider Demographics
NPI:1346336831
Name:TILSON, RICHARD S (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:S
Last Name:TILSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:600 PRIMROSE ST STE 203
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-2659
Mailing Address - Country:US
Mailing Address - Phone:978-459-6737
Mailing Address - Fax:978-459-2580
Practice Address - Street 1:41 WELLMAN ST STE 400
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-5161
Practice Address - Country:US
Practice Address - Phone:978-459-6737
Practice Address - Fax:855-818-1869
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2025-01-20
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Provider Licenses
StateLicense IDTaxonomies
MA208339207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA405299OtherTUFTS HEALTH PLAN
MA0027528OtherNEIGHBORHOOD HEALTH PLAN
MA693290OtherHARVARD PILGRIM
MAJ25362OtherBLUE CROSS
MA0177181Medicaid
MA3670044-002OtherCIGNA
MA0177181Medicaid
MAA34874Medicare PIN