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NPI Code Detail

MEDICARE: DR. POLYXENI GUDIS DO

MEDICARE: DR. POLYXENI GUDIS DO
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
1207Q00000XFamily Medicine Physician25MB11400500NJ
2390200000XStudent in an Organized Health Care Education/Training Program
3208M00000XHospitalist Physician294800MA

General Provider Information

NPI Number : 1275190993
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. POLYXENI GUDIS DO
Provider Business Mailing Address
First Line : 211 PARK ST
Second Line :
City : ATTLEBORO
State : MA
Zip : 02703-3143
Country : US
Telephone Number : 508-222-5200
Fax Number : 508-236-7335
Provider Business Practice Location Address
First Line : 211 PARK ST
Second Line :
City : ATTLEBORO
State : MA
Zip : 02703-3143
Country : US
Telephone Number : 508-222-5200
Fax Number : 508-023-6733
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2019
Last Update Date : 05/24/2026

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