Provider Demographics
NPI:1851374656
Name:OGRADY, JOHN P (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:OGRADY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 410
Mailing Address - Street 2:MERCY INPATIENT MEDICAL ASSOCIATES
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01021-0410
Mailing Address - Country:US
Mailing Address - Phone:413-789-8027
Mailing Address - Fax:413-789-8041
Practice Address - Street 1:271 CAREW ST
Practice Address - Street 2:MERCY INPATIENT MEDICAL ASSOCIATES
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-2377
Practice Address - Country:US
Practice Address - Phone:413-748-7226
Practice Address - Fax:413-748-7285
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2008-01-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA71581207VM0101X
CAG26652207VM0101X
OH207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3051421Medicaid
MAJ08784OtherBLUE CROSS BLUE SHIELD
MA3051421Medicaid
MAJ08784OtherBLUE CROSS BLUE SHIELD
A15699Medicare UPIN