Individual
DR. ANDRES D MOGOLLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
475 FRANKLIN ST, SUITE 110, FRAMINGHAM, MA 01702-6264
(508) 620-9200
(508) 620-6483
Mailing address
475 FRANKLIN ST, SUITE 110, FRAMINGHAM, MA 01702-6264
(508) 620-9200
(508) 620-6483
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
223378
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001341001
MEDICARE
MA
05
—
110084595A
—
MA
Enumeration date
04/12/2007
Last updated
12/29/2015
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