Individual
GIOVANNI A D'AMBROSIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
26 CITY HALL MALL, INTERNAL MEDICINE, MEDFORD, MA 02155-4754
(781) 306-5323
(781) 306-5387
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8374
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
48496
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
048496
TUFTS
MA
05
—
3049418
—
MA
01
—
J02194
BLUE CROSS
MA
01
—
PM162
HARVARD PILGRIM
MA
Enumeration date
02/09/2006
Last updated
11/16/2020
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