Provider Demographics
NPI:1780661843
Name:SANGHA, SIMREN (MD)
Entity Type:Individual
Prefix:
First Name:SIMREN
Middle Name:
Last Name:SANGHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:541 MAIN ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SOUTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1868
Mailing Address - Country:US
Mailing Address - Phone:781-952-1200
Mailing Address - Fax:781-340-1610
Practice Address - Street 1:541 MAIN ST
Practice Address - Street 2:SUITE 400
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1868
Practice Address - Country:US
Practice Address - Phone:781-952-1200
Practice Address - Fax:781-340-1610
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA220257207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ27568OtherBLUE CROSS BLUE SHIELD
MA92323OtherFALLON COMM HEALTH PLAN
MA0036424OtherNEIGHBORHOOD HEALTH PLAN
MA469209OtherTUFTS HEALTH PLAN
MA2064740Medicaid
MAAA13429OtherHARVARD PILGRIM
MA92323OtherFALLON COMM HEALTH PLAN
MAAA13429OtherHARVARD PILGRIM
MA469209OtherTUFTS HEALTH PLAN