Provider Demographics
NPI:1154303808
Name:GARASIC, JOSEPH MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:GARASIC
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIANS ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-726-0712
Mailing Address - Fax:617-726-3539
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:CARDIAC CATHETERIZATION LAB MGH
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-0712
Practice Address - Fax:617-726-3539
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2013-10-01
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Provider Licenses
StateLicense IDTaxonomies
MA151324207R00000X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA455113OtherTUFTS HEALTH PLAN
MA0123650Medicaid
MAJ22743OtherBCBS MA
MA0123650Medicaid
MAJ22743OtherBCBS MA