MEDICARE: ELENA E SMAGINA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	231164	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	J41869	OTHER	MA	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871625756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELENA E SMAGINA MD

Provider Business Mailing Address
First Line	:	PO BOX 415348
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02241-5348
Country	:	US
Telephone Number	:	8-225-8885
Fax Number	:	508-334-1977

Provider Business Practice Location Address
First Line	:	15 WEST ST
Second Line	:
City	:	EAST DOUGLAS
State	:	MA
Zip	:	01516-2160
Country	:	US
Telephone Number	:	85-476-3291
Fax Number	:	508-547-6044

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	04/18/2024

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Directions to “ ELENA E SMAGINA MD” Practice Location

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