Individual
DR. IGOR F PALACIOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, GRB 800, BOSTON, MA 02114-2696
(617) 726-8424
(617) 726-6800
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 726-8424
(617) 726-6800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
44809
MA
207RC0000X
Cardiovascular Disease Physician
44809
MA
207RI0011X
Interventional Cardiology Physician
Primary
44809
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0117765
—
MA
01
—
718363
TUFTS HEALTH PLAN
MA
01
—
E05274
BCBS MA
MA
Enumeration date
10/27/2005
Last updated
11/26/2012
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