Provider Demographics
NPI:1528058781
Name:GILSON, MEREDITH PAIGE (MD)
Entity type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:PAIGE
Last Name:GILSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:139 SANDWICH ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2449
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 TECHNOLOGY PARK DR
Practice Address - Street 2:SUITE A
Practice Address - City:BOURNE
Practice Address - State:MA
Practice Address - Zip Code:02532-8341
Practice Address - Country:US
Practice Address - Phone:508-743-9543
Practice Address - Fax:508-743-8335
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-27
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA224177207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000033881OtherBMC HEALTHNET PLAN
MA491654OtherUS FAMILY HEALTH
MAJ29956OtherBCBSMA
MA494744OtherTUFTS HEALTH PLAN
MAAA61334OtherHARVARD PILGRIM
MA2117029Medicaid
MA1166205OtherAETNA US HEALTHCARE
MAAA61334OtherHARVARD PILGRIM
MA2117029Medicaid