Provider Demographics
NPI:1063490431
Name:SHERWOOD, GEOFFREY KRAY (MD)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:KRAY
Last Name:SHERWOOD
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 1:1153 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3446
Mailing Address - Country:US
Mailing Address - Phone:617-983-4734
Mailing Address - Fax:617-983-4735
Practice Address - Street 1:1153 CENTRE ST
Practice Address - Street 2:DFCI/BWH CANCER CLINIC AT FAULKNER HOSPITAL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02130-3446
Practice Address - Country:US
Practice Address - Phone:617-983-7160
Practice Address - Fax:617-983-7860
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA38173207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA4403877OtherCIGNA
MAV03176OtherBLUE CROSS BLUE SHIELD
MA9477OtherHARVARD PILGRIM HEALTH CA
MA9766553Medicaid
MAA66841Medicare UPIN
MAV03176OtherBLUE CROSS BLUE SHIELD