Provider Demographics
NPI:1982604328
Name:GUMP, MARGUERITE C (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGUERITE
Middle Name:C
Last Name:GUMP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARGUERITE
Other - Middle Name:ANN
Other - Last Name:CADWALLADER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 8019
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01102-8000
Mailing Address - Country:US
Mailing Address - Phone:866-431-4077
Mailing Address - Fax:413-774-7448
Practice Address - Street 1:329 CONWAY ST
Practice Address - Street 2:GREENFIELD HEALTH CENTER
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-1526
Practice Address - Country:US
Practice Address - Phone:413-774-6301
Practice Address - Fax:413-774-6528
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA221181207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA467559OtherTUFTS HEALTH PLAN
MAP00155321OtherRAILROAD MEDICARE
MA221181OtherCONNECTICARE OF MA
MAJ27987OtherBLUE CROSS & BLUE SHIELD
MA000000028883OtherBOSTON MEDICAL CENTER HEALTHNET PLAN
MA491533OtherUS FAMILY HEALTH PLAN
MA94261OtherFALLON COMMUNITY HEALTH PLAN
MA0086357OtherCIGNA HEALTH PLANS
MA34968OtherHEALTH NEW ENGLAND
MAAA19114OtherHARVARD PILGRIM HEALTHCARE
MA2082900Medicaid
MA3640624OtherAETNA US HEALTHCARE
MA94261OtherFALLON COMMUNITY HEALTH PLAN
MA0086357OtherCIGNA HEALTH PLANS
MA221181OtherCONNECTICARE OF MA