Provider Demographics
NPI:1538116223
Name:MARCAL, JOSE MANUEL JR (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:MANUEL
Last Name:MARCAL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:91 MONTVALE AVE
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-3623
Mailing Address - Country:US
Mailing Address - Phone:781-438-5565
Mailing Address - Fax:781-438-5588
Practice Address - Street 1:3 WOODLAND RD
Practice Address - Street 2:SUITE 306
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-1702
Practice Address - Country:US
Practice Address - Phone:781-665-3380
Practice Address - Fax:781-665-4162
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2012-11-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA49328207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD700560OtherTUFTS HEALTH PLAN
MAB00083OtherBLUE CROSS & BLUE SHIELD
MA30031OtherHARVARD PILGRIM HEALTH
MA0191558Medicaid
MAB00083OtherBLUE CROSS & BLUE SHIELD
MAB72556Medicare UPIN