Provider Demographics
NPI:1477531358
Name:KOOMEY, JAMES MATTHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MATTHEW
Last Name:KOOMEY
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 1:275 SANDWICH ST
Mailing Address - Street 2:C/O CATHY GREY
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2183
Mailing Address - Country:US
Mailing Address - Phone:508-830-2390
Mailing Address - Fax:508-830-2399
Practice Address - Street 1:275 SANDWICH ST
Practice Address - Street 2:C/O CATHY GREY
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-2183
Practice Address - Country:US
Practice Address - Phone:508-830-2390
Practice Address - Fax:508-830-2399
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA155230207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3178391Medicaid
MAJ19174OtherBCBSMA
MA14734OtherHARVARD PILGRIM
MA779429OtherTUFTS HEALTH PLAN
MAJ19174OtherBCBSMA
MA3178391Medicaid