Provider Demographics
NPI:1093734220
Name:CLAIRMONT, GEORGE J (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:J
Last Name:CLAIRMONT
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 1:362 N BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:EAST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02333-1148
Mailing Address - Country:US
Mailing Address - Phone:508-350-2350
Mailing Address - Fax:508-350-2318
Practice Address - Street 1:673 BEDFORD ST
Practice Address - Street 2:RTE 18
Practice Address - City:ABINGTON
Practice Address - State:MA
Practice Address - Zip Code:02351
Practice Address - Country:US
Practice Address - Phone:781-878-1903
Practice Address - Fax:781-982-0387
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA53790207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MACX1704OtherMEDICARE PTAN
MAJ04281OtherBC/BS
MA61510OtherHPHC
MA716367OtherTAHP
MA3195741Medicaid
MACX1704OtherMEDICARE PTAN
MA61510OtherHPHC