Provider Demographics
NPI:1992843049
Name:MICHAEL B GINSBERG MD PC
Entity Type:Organization
Organization Name:MICHAEL B GINSBERG MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:GINSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-969-1526
Mailing Address - Street 1:375 DUDLEY RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-2808
Mailing Address - Country:US
Mailing Address - Phone:617-969-1526
Mailing Address - Fax:
Practice Address - Street 1:375 DUDLEY RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-2808
Practice Address - Country:US
Practice Address - Phone:617-969-1526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9754962Medicaid
MA9754962Medicaid