Provider Demographics
NPI:1437257227
Name:BERSHEL, DEBORAH (MD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:
Last Name:BERSHEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ROY
Other - Middle Name:
Other - Last Name:BERKOWITZ-SHELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:260 ELM ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-2951
Mailing Address - Country:US
Mailing Address - Phone:617-666-9577
Mailing Address - Fax:617-666-3190
Practice Address - Street 1:260 ELM ST
Practice Address - Street 2:SUITE 105
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-2951
Practice Address - Country:US
Practice Address - Phone:617-666-9577
Practice Address - Fax:617-666-3190
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA60194207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA710390OtherTUFTS HEALTH CARE
MA996748OtherNETWORK HEALTH
MA7583OtherHARVARD PILGRIM HEALTH
MA3036642OtherCIGNA
MA3036642Medicaid
MA1280812OtherFALLON HEALTH PLAN
MA3036642OtherBCBS
MA3036642OtherBCBS
MA3036642OtherCIGNA