Provider Demographics
NPI:1629386057
Name:RICE, GREGORY DAVID (MBBS, MS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:DAVID
Last Name:RICE
Suffix:
Gender:M
Credentials:MBBS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 POND AVE
Mailing Address - Street 2:APARTMENT 208
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-7129
Mailing Address - Country:US
Mailing Address - Phone:617-943-8580
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:DIVISION OF CARDIAC SURGERY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-732-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA245605390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program