Provider Demographics
NPI:1467443341
Name:SIMMONS, PAUL IRWIN (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:IRWIN
Last Name:SIMMONS
Suffix:
Gender:M
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:617-726-4077
Mailing Address - Fax:617-724-8067
Practice Address - Street 1:50 STANIFORD ST
Practice Address - Street 2:3RD FLOOR S50 3 300 MASS GENERAL MEDICAL GROUP
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2517
Practice Address - Country:US
Practice Address - Phone:617-724-8059
Practice Address - Fax:617-724-8067
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2012-07-30
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Provider Licenses
StateLicense IDTaxonomies
MA224030207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA468381OtherTUFTS HEALTH PLAN
MA2101840Medicaid
MAJ28578OtherBCBS MA
MA2101840Medicaid
MAJ28578OtherBCBS MA