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Individual

ERIC DAVID LIBBY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
955 MAIN ST, WINCHESTER, MA 01890-4302
(781) 729-5855
Mailing address
955 MAIN ST, SUITE 206, WINCHESTER, MA 01890-4302
(781) 729-5855

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
79352
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
079352
TUFTS HEALTH
MA
01
303380
HARVARD PILGRIM HEALTH
05
3126072
MA
01
509647
US HEALTH
MA
01
J30490
BLUE CROSS & BLUE SHIELD
MA
Enumeration date
06/07/2006
Last updated
11/06/2012
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