Provider Demographics
NPI:1639272818
Name:GIRAGOS, JOHN G JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:G
Last Name:GIRAGOS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:585 LEBANON ST
Mailing Address - Street 2:MELROSE WAKEFIELD HOSPITAL
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-3225
Mailing Address - Country:US
Mailing Address - Phone:781-979-3310
Mailing Address - Fax:781-979-3326
Practice Address - Street 1:585 LEBANON ST
Practice Address - Street 2:MELROSE WAKEFIELD HOSPITAL
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-3225
Practice Address - Country:US
Practice Address - Phone:781-979-3310
Practice Address - Fax:781-979-3326
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA152638207R00000X, 207RG0300X, 2084P0800X
NH211482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA152638OtherMA PHYSICIAN LICENSE NUMBER
NH3126089Medicaid