Provider Demographics
NPI:1568453033
Name:GOROLL, ALLAN HAROLD (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:HAROLD
Last Name:GOROLL
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:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:15 PARKMAN ST
Practice Address - Street 2:WAC 645
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-726-2368
Practice Address - Fax:617-726-6861
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MA37804207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM09323OtherBCBS MA
MA037804OtherTUFTS HEALTH PLAN
MA2047284Medicaid
MA037804OtherTUFTS HEALTH PLAN
MA2047284Medicaid