Individual
DR. GINA M MASSOGLIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2009 TIDEWATER COLONY WAY, SUITE 2A, ANNAPOLIS, MD 21401-2127
(410) 571-9499
(410) 571-6488
Mailing address
PO BOX 64421, BALTIMORE, MD 21264-4421
(410) 280-6576
(410) 280-6515
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
D0047906
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001
BCBS
—
01
—
3982225
AETNA HMO
—
01
—
472339
MAMSI
—
01
—
54273301
BCBS
—
01
—
610703600
FEDERAL WORKMAN'S COMP
—
01
—
7556029
AETNA PPO
—
Enumeration date
10/10/2005
Last updated
04/19/2010
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