Individual
CHARLES MASON FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15 PARKMAN ST, WAC 465, BOSTON, MA 02114-3117
(617) 724-6915
(617) 724-6802
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
208600000X
Surgery Physician
Primary
47435
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
047435
TUFTS HEALTH PLAN
MA
05
—
3083268
—
MA
01
—
E05679
BCBS MA
MA
Enumeration date
11/02/2005
Last updated
08/07/2013
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