MEDICARE: JOHN G STAGIAS MD PC

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	207RG0100X	Gastroenterology Physician	80381	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	983813	OTHER	MA	NETWORK HEALTH
2	S029063	OTHER	MA	CHAMPUS
3	010080381MA01	OTHER	CT	ANTHEM BCBS
4	452850	OTHER	MA	AETNA US HEALTHCARE
5	64553	OTHER	MA	HARVARD PILGRIM
6	080381	OTHER	MA	TUFTS
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	21577	OTHER	MA	FALLON COM HEAOTH PLAN
9	33988	OTHER	MA	BMC
10	M16031	OTHER	MA	BCBS

General Provider Information

NPI Number	:	1992913982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN G STAGIAS MD PC

Provider Business Mailing Address
First Line	:	428 HAMILTON ST
Second Line	:
City	:	SOUTHBRIDGE
State	:	MA
Zip	:	01550-1859
Country	:	US
Telephone Number	:	508-765-1600
Fax Number	:	508-764-2502

Provider Business Practice Location Address
First Line	:	428 HAMILTON ST
Second Line	:
City	:	SOUTHBRIDGE
State	:	MA
Zip	:	01550-1859
Country	:	US
Telephone Number	:	508-765-1600
Fax Number	:	508-764-2502

Authorized Official
Title or Position	:	DR JOHN G STAGIAS
Name	:	DR. JOHN GUS STAGIAS
Credential	:	MD
Telephone Number	:	508-765-1600

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	08/22/2020

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