MEDICARE: GERALD G TANGUILIG M.D.

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	207W00000X	Ophthalmology Physician	160753	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679562789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERALD G TANGUILIG M.D.

Provider Business Mailing Address
First Line	:	97 LIBBEY INDUSTRIAL PKWY STE 100
Second Line	:
City	:	EAST WEYMOUTH
State	:	MA
Zip	:	02189-3110
Country	:	US
Telephone Number	:	781-331-3300
Fax Number	:	781-337-8356

Provider Business Practice Location Address
First Line	:	23 WHITES PATH
Second Line	:
City	:	SOUTH YARMOUTH
State	:	MA
Zip	:	02664-1221
Country	:	US
Telephone Number	:	508-398-6131
Fax Number	:	508-398-7440

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

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	12/23/2021

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