Individual
DR. GODTFRED HOLMVANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
139 MAIN ST, BOSTON HEART FOUNDATION, CAMBRIDGE, MA 02142-1530
(617) 726-4150
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-6824
(617) 726-3852
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
60102
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060102
TUFTS HEALTH PLAN
MA
05
—
3060900
—
MA
01
—
J09026
BCBS MA
MA
Enumeration date
10/26/2005
Last updated
07/31/2012
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