Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 80381 | MA |
NPI | 1023012424 |
---|---|
Provider Name | Dr. John Gus Stagias |
First Address | Sturbridge, MA 01566-0250 |
Second Address | Southbridge, MA 01550-1859 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2005 |
Last Update Date | 21/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010080381MA01 | ANTHEM BCBS (01) | CT |
080381 | TUFTS (01) | MA |
110088781 | RR MEDICARE (01) | MA |
21577 | FALLON COM HEALTH PLAN (01) | MA |
33988 | BMC (01) | MA |
452850 | AETNA US HEALTHCARE (01) | MA |
64553 | HARVARD PILGLRIM (01) | MA |
9773916 | (05) | MA |
983813 | NETWORK HEALTH (01) | MA |
F34645 | (02) | MA |
J14840 | BCBS (01) | MA |
S029063 | CHAMPUS (01) | MA |