Organization
HIGH PERFORMANCE SPORTS MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK P. GILLIGAN MD (PRESIDENT)
(978) 921-7590
Entity
Organization
Contact information
Practice address
900 CUMMINGS CTR, SUITE 130-U, BEVERLY, MA 01915-6198
(978) 921-7590
(978) 921-7597
Mailing address
900 CUMMINGS CTR, SUITE 130-U, BEVERLY, MA 01915-6198
(978) 921-7590
(978) 921-7597
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0028303
NEIGHBORHOOD HEALTH PLAN
—
01
—
171031
HARVARD PILGRIM
—
01
—
2998140
AETNA
—
01
—
693840
TUFTS HEALTH PLAN
—
05
—
9723820
—
MA
01
—
DC0756
RAILROAD MEDICARE
—
01
—
M18148
BLUE CROSS BLUE SHIELD
MA
01
—
M21205
MEDICARE PTAN
—
Enumeration date
08/25/2005
Last updated
11/07/2014
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