Provider Demographics
NPI:1427050640
Name:BILAZARIAN, SETH D (MD)
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:D
Last Name:BILAZARIAN
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 1:73 BARTLET ST
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-4138
Mailing Address - Country:US
Mailing Address - Phone:978-474-0579
Mailing Address - Fax:
Practice Address - Street 1:22 CHERRY HILL DR
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-2575
Practice Address - Country:US
Practice Address - Phone:978-646-1810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA70372207RC0000X, 207RI0011X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA070372OtherTUFTS HEALTH PLAN
678827OtherHEALTHSOURCE
975005OtherNETWORK HEALTH
4365271OtherAETNA - NON-HMO
8531511OtherCIGNA
MAJ09571OtherBLUE CROSS BLUE SHIELD
0011267OtherNEIGHBORHOOD HEALTH PLAN
MA3066169Medicaid
060061828OtherRAILROAD MEDICARE
1427050640OtherAETNA - HMO
NHE65588OtherANTHEM BLUE CROSS
25-01622OtherEVERCARE
MA273451OtherHARVARD PILGRIM HEALTHCAR
NH30201624OtherNEW HAMPSHIRE MEDICAID
NHE65588OtherANTHEM BLUE CROSS
MA/E65588Medicare UPIN