Individual
PATRICIA DEGROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
147 MILK ST, PROVIDER ENROLLMENT 9TH FLOOR, BOSTON, MA 02109-4806
(617) 654-7280
(617) 654-7363
Mailing address
147 MILK ST, PROVIDER ENROLLMENT 9TH FLOOR, BOSTON, MA 02109-4806
(617) 654-7280
(617) 654-7363
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
79172
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0014811
NEIGHBORHOOD HEALTH PLAN
MA
01
—
079172
TUFTS HEALTH PLAN
MA
01
—
1591495-002
CIGNA
MA
05
—
3187926
—
MA
01
—
G400
HARVARD PILGRIM
MA
01
—
J30762
BLUE CROSS
MA
Enumeration date
05/04/2006
Last updated
02/10/2021
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