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Individual

DR. COSMAS CHRIS GIALLOURAKIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
55 FRUIT ST BLK4, GASTROENTEROLOGY ASSOCIATES, BOSTON, MA 02114-2696
(617) 724-6113
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-2026
(617) 724-6832

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
209147
MA
207RG0100X
Gastroenterology Physician
Primary
209147
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2111900
MA
01
478876
TUFTS HEALTH PLAN
MA
01
J29715
BCBS MA
MA
Enumeration date
08/19/2006
Last updated
12/14/2012
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