Provider Demographics
NPI:1881684439
Name:PINGREE, RICHARD GRAHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:GRAHAM
Last Name:PINGREE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-726-2375
Mailing Address - Fax:617-724-2814
Practice Address - Street 1:15 PARKMAN ST
Practice Address - Street 2:WAC 625 INTERNAL MEDICINE ASSOCIATES TEAM 1
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-726-2375
Practice Address - Fax:617-724-2814
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2013-02-19
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Provider Licenses
StateLicense IDTaxonomies
MA36843207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2046873Medicaid
MAM08685OtherBCBS MA
MA036843OtherTUFTS HEALTH PLAN
MA036843OtherTUFTS HEALTH PLAN
MAM08685Medicare PIN