Provider Demographics
NPI:1568445427
Name:SMITH, GREGORY J (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:J
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:110 W SQUANTUM ST
Mailing Address - Street 2:
Mailing Address - City:NORTH QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-2122
Mailing Address - Country:US
Mailing Address - Phone:617-376-3000
Mailing Address - Fax:617-774-1905
Practice Address - Street 1:110 W SQUANTUM ST
Practice Address - Street 2:
Practice Address - City:NORTH QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02171-2122
Practice Address - Country:US
Practice Address - Phone:617-376-3000
Practice Address - Fax:617-774-1905
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2016-01-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA58595207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA058595OtherTUFTS MEDICARE PREFERRED
MA0016428OtherNEIGHBORHOOD HLTH PLAN
MA042297845OtherHCVM
MA042297845OtherTRICARE
MA042297845OtherDOC FIRST
MA4219050OtherAETNA
MA042297845OtherPRIVATE HEALTHCARE SYSTEM
MA042297845OtherUNITED HEALTH CARE
MA058595OtherTUFTS
MA3026191Medicaid
MAB10355401OtherCIGNA
MAJ07003OtherBCBS
MA042297845OtherGREAT WEST HEALTH CARE
MA62309OtherHVD PILGRIM HEALTH CARE
MA042297845OtherTRICARE
MA62309OtherHVD PILGRIM HEALTH CARE