Provider Demographics
NPI:1083691935
Name:HU, LAURA J (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:J
Last Name:HU
Suffix:
Gender:F
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: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:617-724-8400
Mailing Address - Fax:617-724-0331
Practice Address - Street 1:15 PARKMAN STREET
Practice Address - Street 2:WAC605 INTERNAL MEDICINE ASSOCIATES TEAM 2
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-724-8400
Practice Address - Fax:617-724-0331
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA158259207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0153800Medicaid
MAJ23895OtherBCBS MA
MA158259OtherTUFTS HEALTH PLAN
MAJ23895OtherBCBS MA
H46845Medicare UPIN