Individual
DR. MARK J SIMONELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 SOUTH ST, SUITE G05, SOUTHBRIDGE, MA 01550-4051
(508) 765-5981
(508) 764-4637
Mailing address
100 SOUTH ST, SUITE G05, SOUTHBRIDGE, MA 01550-4051
(508) 765-5981
(508) 764-4637
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
75660
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3098001
—
MA
Enumeration date
09/08/2005
Last updated
12/21/2011
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