Individual
DR. MICHELE TRUCKSIS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD PHD
Contact information
Practice address
55 FRUIT ST, INFECTIOUS DISEASE ASSOCIATES GRJ 504, BOSTON, MA 02114-2696
(617) 726-3812
(617) 726-7416
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
207R00000X
Internal Medicine Physician
Primary
58871
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
058871
TUFTS HEALTH PLAN
MA
05
—
3046788
—
MA
01
—
J08862
BCBS MA
MA
Enumeration date
10/25/2005
Last updated
07/08/2007
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