Basic Information
| Provider Information | |||||||||
| NPI: | 1487630935 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NAJJAR | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | G | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 630 PLANTATION ST | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5083683190 | ||||||||
| FaxNumber: | 5083683193 | ||||||||
| Practice Location | |||||||||
| Address1: | 123 SUMMER ST | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016081312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5083683190 | ||||||||
| FaxNumber: | 5083683193 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2005 | ||||||||
| LastUpdateDate: | 02/20/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 210201 | MA | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0129X | 210201 | MA | Y | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
ID Information
| ID | Type | State | Issuer | Description | 042472266 | 01 | TRICARE CHAMPUS | OTHER | 0142701 | 01 | HEALTHY START | OTHER | J23719 | 01 | BLUE SHIELD HMO BLUE | OTHER | 0142701 | 01 | WELFARE | OTHER | 042472266 | 01 | HEALTHCARE VALUE MANAGEME | OTHER | 7258566 | 01 | AETNA US HEALTHCARE | OTHER | 784058 | 01 | MVP HEALTH CARE | OTHER | AA4381 | 01 | HARVARD PILGRIM HEALTHCAR | OTHER | 042472266 | 01 | PRIVATE HEALTHCARE SYSTEM | OTHER | J23719 | 01 | BLUE CARE ELECT | OTHER | 042472266 | 01 | ONE HEALTH PLAN | OTHER | 6272907 | 01 | CIGNA HEALTH PLAN | OTHER | J23719 | 01 | BLUE SHIELD INDEMNITY | OTHER | 042472266 | 01 | THREE RIVERS | OTHER | 1927085 | 01 | FIRST HEALTH | OTHER | 3700073 | 01 | EVERCARE | OTHER | 61247 | 01 | FALLON COMMUNITY HEALTH | OTHER |