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Organization

SP GANGULY MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SYAMA GANGULY MD (PRESIDENT)
(508) 238-8646
Entity
Organization

Contact information

Practice address
55 FOGG RD, WEYMOUTH, MA 02190-2432
(781) 340-8000
Mailing address
944 WASHINGTON ST, SUITE 1, SOUTH EASTON, MA 02375-1177
(508) 238-8646
(508) 230-9772

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
32940
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9734341
MA
01
M21884
BLUE SHIELD
MA
Enumeration date
04/19/2007
Last updated
04/05/2013
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