Provider Demographics
NPI:1407980600
Name:PRICE, JANET M (MD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:M
Last Name:PRICE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PROVIDER ENROLLMENT
Mailing Address - Street 2:100 FRONT STREET 12TH FLOOR
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608
Mailing Address - Country:US
Mailing Address - Phone:508-368-5510
Mailing Address - Fax:508-368-5530
Practice Address - Street 1:425 NORTH LAKE AVE
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605
Practice Address - Country:US
Practice Address - Phone:508-595-2855
Practice Address - Fax:508-595-2602
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA76666207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
6014176OtherCIGNA
44950OtherFALLON COMMUNITY HEALTH
32-00039OtherEVERCARE
4484902OtherAETNA
MAJ13062OtherBLUE CROSS BLUE SHIELD
076666OtherTUFTS HEALTH PLAN
MA3101215Medicaid
AA22558OtherHARVARD PILGRIM
32-00039OtherEVERCARE
MAJ13062Medicare ID - Type Unspecified