Provider Demographics
NPI:1023008331
Name:SGROI, DENNIS C (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:C
Last Name:SGROI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:149 13TH ST
Practice Address - Street 2:CNY 7
Practice Address - City:CHARLESTOWN
Practice Address - State:MA
Practice Address - Zip Code:02129-2020
Practice Address - Country:US
Practice Address - Phone:617-726-5697
Practice Address - Fax:617-726-5684
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA77231207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA750163OtherTUFTS HEALTH PLAN
MAJ14185OtherBCBS MA
MA750163OtherTUFTS HEALTH PLAN
MA3115593Medicare ID - Type Unspecified
MAJ14185OtherBCBS MA