Individual
DR. GUY SCOTT GAZELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD MPH PHD
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 726-4047
(617) 726-9414
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-4047
(617) 726-9414
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
74000
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3083217
—
MA
01
—
726286
TUFTS HEALTH PLAN
MA
01
—
J11580
BCBS MA
MA
Enumeration date
10/31/2005
Last updated
11/01/2018
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