Provider Demographics
NPI:1912975046
Name:HOBBS, ELEANOR T (MD)
Entity Type:Individual
Prefix:
First Name:ELEANOR
Middle Name:T
Last Name:HOBBS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 HOLLAND ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-2705
Mailing Address - Country:US
Mailing Address - Phone:617-629-6350
Mailing Address - Fax:617-629-6067
Practice Address - Street 1:40 HOLLAND ST
Practice Address - Street 2:INTERNAL MEDICINE
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-2705
Practice Address - Country:US
Practice Address - Phone:617-629-6350
Practice Address - Fax:617-629-6067
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA38768207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6167381Medicaid
MA712773OtherTUFTS
MAAA24264OtherHARVARD PILGRIM
MAB07187OtherBLUE CROSS
MAB72662Medicare UPIN
MAB07187Medicare PIN