Provider Demographics
NPI:1457336810
Name:SIMMONS, VIRGINIA A (MD)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:A
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VIRGINIA
Other - Middle Name:A
Other - Last Name:ASKEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2000 WASHINGTON ST
Mailing Address - Street 2:STE 764
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1628
Mailing Address - Country:US
Mailing Address - Phone:617-965-7800
Mailing Address - Fax:617-965-4581
Practice Address - Street 1:2000 WASHINGTON ST
Practice Address - Street 2:STE 764
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1628
Practice Address - Country:US
Practice Address - Phone:617-965-7800
Practice Address - Fax:617-965-4581
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA219556207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
043200332OtherSTANDARD TAX ID
MAJ27218OtherBCBS
0017071OtherNEIGHBORHOOD HEALTH
AA11921OtherHPHC
MA468751OtherTUFTS HEALTH PLAN
468751OtherTUFTS
468751OtherTUFTS
MAJ27218OtherBCBS