Individual
DR. LEO CHARLES GINNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, WHITE 905, BOSTON, MA 02114-2621
(617) 726-1718
(617) 724-1792
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
37980
MA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
37980
MA
207RP1001X
Pulmonary Disease Physician
Primary
37980
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
037980
TUFTS HEALTH PLAN
MA
05
—
2067641
—
MA
01
—
B14078
BCBS MA
MA
Enumeration date
11/02/2005
Last updated
09/28/2011
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