Individual
DR. MARC JAY SEMIGRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, GREY BIGELOW 840, BOSTON, MA 02114-2696
(617) 726-8862
(617) 726-4105
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 726-8862
(617) 726-4105
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
53859
MA
207RC0000X
Cardiovascular Disease Physician
Primary
53859
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3044173
—
MA
01
—
713854
TUFTS HEALTH PLAN
MA
01
—
J04904
BCBS MA
MA
Enumeration date
01/25/2006
Last updated
02/11/2014
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