Provider Demographics
NPI:1487630935
Name:NAJJAR, JOHN G (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:G
Last Name:NAJJAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:630 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605
Mailing Address - Country:US
Mailing Address - Phone:508-368-3190
Mailing Address - Fax:508-368-3193
Practice Address - Street 1:123 SUMMER ST
Practice Address - Street 2:SUITE 210
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1312
Practice Address - Country:US
Practice Address - Phone:508-368-3190
Practice Address - Fax:508-368-3193
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA210201208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
042472266OtherTRICARE CHAMPUS
0142701OtherHEALTHY START
J23719OtherBLUE SHIELD HMO BLUE
0142701OtherWELFARE
042472266OtherHEALTHCARE VALUE MANAGEME
7258566OtherAETNA US HEALTHCARE
784058OtherMVP HEALTH CARE
AA4381OtherHARVARD PILGRIM HEALTHCAR
042472266OtherPRIVATE HEALTHCARE SYSTEM
J23719OtherBLUE CARE ELECT
042472266OtherONE HEALTH PLAN
6272907OtherCIGNA HEALTH PLAN
J23719OtherBLUE SHIELD INDEMNITY
042472266OtherTHREE RIVERS
1927085OtherFIRST HEALTH
3700073OtherEVERCARE
61247OtherFALLON COMMUNITY HEALTH
042472266OtherTRICARE CHAMPUS
3700073OtherEVERCARE
A33606Medicare ID - Type UnspecifiedB