Provider Demographics
NPI:1952394355
Name:BLAGG, NOEL (MD)
Entity Type:Individual
Prefix:DR
First Name:NOEL
Middle Name:
Last Name:BLAGG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:777 NORTH ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4147
Mailing Address - Country:US
Mailing Address - Phone:413-499-8510
Mailing Address - Fax:413-499-8553
Practice Address - Street 1:777 NORTH ST
Practice Address - Street 2:SUITE 207
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4147
Practice Address - Country:US
Practice Address - Phone:413-499-8510
Practice Address - Fax:413-499-8553
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA39360207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110212119OtherRAILROAD MEDICARE
MA043531502OtherGIC INDEMNITY
MA043531502OtherHMC PPO
MA10655OtherHEALTH NEW ENGLAND
MA113335OtherMVP
MA039360OtherTUFTS
MAD82852OtherHARVARD
MA000000020926OtherHEALTHNET
MA0167916Medicaid
MA10034412OtherCAPITAL PHYSICIANS HEALTH
MA043531502OtherCIGNA INDEMNITY
MI3871967OtherCIGNA/HEALTHSOURCE HMO
MAI22278OtherBCBS
MA043531502OtherCIGNA INDEMNITY
MA110212119OtherRAILROAD MEDICARE