Provider Demographics
NPI:1598722837
Name:GAGNE, GEORGE FRANCIS (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:FRANCIS
Last Name:GAGNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:481 BEDFORD ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02324-3152
Mailing Address - Country:US
Mailing Address - Phone:508-697-3123
Mailing Address - Fax:508-279-1630
Practice Address - Street 1:481 BEDFORD ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02324-3152
Practice Address - Country:US
Practice Address - Phone:508-697-3123
Practice Address - Fax:508-279-1630
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA52573207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA04-04276OtherEVERCARE
MAS010488OtherCHAMPUS
MA517180OtherCIGNA HMO
MAB1040680OtherCIGNA PPO
MA6179OtherHARVARD PILGRIM
MA110010425OtherRAILROAD MEDICARE
MA9077131OtherPHCS
MA04-2834328OtherGIC
MA0441133OtherUNITED HEALTHCARE
MA6179525Medicaid
MA711266OtherTUFTS
MA04-2834328OtherGIC
MAA57003Medicare UPIN