Provider Demographics
NPI:1174520563
Name:GILLIES, ANDREW J (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:GILLIES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:980 WASHINGTON ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-6731
Mailing Address - Country:US
Mailing Address - Phone:781-251-2222
Mailing Address - Fax:781-234-0279
Practice Address - Street 1:980 WASHINGTON ST
Practice Address - Street 2:SUITE 120
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-6731
Practice Address - Country:US
Practice Address - Phone:781-251-2222
Practice Address - Fax:781-234-0279
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2011-11-15
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Provider Licenses
StateLicense IDTaxonomies
MA55237207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
055237OtherTUFTS
055237OtherTUFTS BENEFIT ADMINISTRAT
B77257OtherFIRST SENIORITY
180009329OtherRAILROAD MEDICARE
7538944OtherHEALTHSOURSCE MASSACHUSET
055237OtherTUFTS COMMONWEALTH PPO
15986OtherHARVARD PILGRIM POS PPO
3031535OtherMASS HEALTH (DIV MED SVCS
J07034OtherBS-BLUE CARE 65
J07034OtherBS-BLUE CARE ELECT
055237OtherTUFTS TOTAL HEALTH PLAN
J07034OtherHMO BLUE/BLUE CHOICE
J07034OtherBLUE SHIELD INDEMNITY
08-00480OtherUNITED HEALTHCARE(HMO&PPO
27410OtherCHILDREN'S MEDICAL SECURI
7538944OtherCIGNA HEALTH CARE
000600OtherNEIGHBORHOOD HEALTH PLAN
055237OtherTUFTS SECURE HORIZONS
7538944OtherHEALTHSOURSCE MASSACHUSET
J07034OtherBS-BLUE CARE 65