Provider Demographics
NPI:1083605208
Name:HOGE, ELIZABETH A (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:A
Last Name:HOGE
Suffix:
Gender:F
Credentials:MD
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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 1:15 PARKMAN ST
Practice Address - Street 2:PSYCHIATRY OUTPATIENT DEPARTMENT
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-724-0859
Practice Address - Fax:617-726-7541
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2012-11-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA2161022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ27658OtherBCBS MA
MA469257OtherTUFTS HEALTH PLAN
MA2070910Medicaid
H83092Medicare UPIN
MAJ27658OtherBCBS MA