Individual
DR. LAWRENCE T GEOGHEGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
77 MASSACHUSETTS AVE, MIT MEDICAL DEPARTMENT E23-300, CAMBRIDGE, MA 02139-4301
(617) 253-4988
(617) 253-7265
Mailing address
77 MASSACHUSETTS AVE, MIT MEDICAL DEPARTMENT E23-300, CAMBRIDGE, MA 02139-4301
(617) 253-4988
(617) 253-7265
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
30208
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0175161
—
MA
01
—
030208
TUFTS
—
01
—
B33229
BCBS
—
01
—
LAM12968
BCBS
—
Enumeration date
10/25/2005
Last updated
12/28/2012
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