Individual
DR. GUNNLAUGUR PETUR NIELSEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST WRN 2, PATHOLOGY ASSOCIATES, BOSTON, MA 02114-2696
(617) 724-1469
(617) 726-9312
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
78780
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
078780
TUFTS HEALTH PLAN
MA
05
—
3124584
—
MA
01
—
J30551
BCBS MA
MA
Enumeration date
03/16/2006
Last updated
07/08/2007
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