Provider Demographics
NPI:1932199106
Name:MOY, BEVERLY (MD)
Entity type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:
Last Name:MOY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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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:617-726-6500
Mailing Address - Fax:617-724-1079
Practice Address - Street 1:100 BLOSSOM ST
Practice Address - Street 2:COX 1
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2606
Practice Address - Country:US
Practice Address - Phone:617-724-4800
Practice Address - Fax:617-724-1684
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2012-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA156942207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ24761OtherBCBS MA
MA156942OtherTUFTS HEALTH PLAN
MA0191001Medicaid
H55793Medicare UPIN
MAA33612Medicare ID - Type Unspecified