Provider Demographics
NPI:1205812310
Name:EMERSON, GEOFFREY W (MD)
Entity type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:W
Last Name:EMERSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2 WEST STREET
Mailing Address - Street 2:STE D
Mailing Address - City:S WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1861
Mailing Address - Country:US
Mailing Address - Phone:781-337-2400
Mailing Address - Fax:781-337-5398
Practice Address - Street 1:2 WEST STREET
Practice Address - Street 2:STE D
Practice Address - City:S WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1861
Practice Address - Country:US
Practice Address - Phone:781-337-2400
Practice Address - Fax:781-337-5398
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2008-04-24
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Provider Licenses
StateLicense IDTaxonomies
MA34519207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA4488236001OtherCIGNA PAL
MA84248OtherAETNA/USHC
MA070360047OtherVSP
MA2045052Medicaid
MAAA29363OtherHARVARD PILGRIM HEALTH CA
MA0800790OtherEVERCARE
MA729116OtherTUFTS HEALTH PLAN
MA2200775OtherUNITED HEALTH CARE
MA2200775OtherUNITED HEALTH CARE
MAA53954Medicare UPIN