Individual
DR. IGNACIO INGLESSIS-AZUAJE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, GRB 852C CARDIAC UNIT ASSOCIATES, BOSTON, MA 02114-2696
(617) 724-8052
(617) 726-6800
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-6800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
212780
MA
207RC0000X
Cardiovascular Disease Physician
Primary
212780
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2007754
—
MA
01
—
212780
TUFTS HEALTH PLAN
MA
01
—
J26107
BCBS MA
MA
Enumeration date
04/27/2006
Last updated
07/15/2009
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