Simonelli, Mark J

Simonelli, Mark J is an individual health care provider with primary practice located at 100 South St Suite G05, Southbridge MA 01550-4051. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Simonelli, Mark J can be contacted via phone (508) 765-5981.

Contact Information

Primary practice address
100 South St Suite G05 Southbridge MA 01550-4051
Phone: (508) 765-5981
Fax: (508) 764-4637
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 75660 Massachusetts

Profile Details

NPI number 1598759334
LBN Legal business name Simonelli, Mark J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 8th, 2005
Last updated Dec 21st, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598759334 NPPES
Massachusetts MEDICAID 3098001

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