Provider Demographics
NPI:1215910963
Name:GOBEL, VERENA (MD)
Entity type:Individual
Prefix:DR
First Name:VERENA
Middle Name:
Last Name:GOBEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-726-2737
Mailing Address - Fax:617-724-0702
Practice Address - Street 1:55 FRUIT STREET
Practice Address - Street 2:YAW 8 B
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-726-2737
Practice Address - Fax:617-724-0702
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA154414207RH0003X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3170071Medicaid
MA725725OtherTUFTS HEALTH PLAN
MAJ17908OtherBCBS MA
MA3170071Medicaid
MAJ17908OtherBCBS MA