Provider Demographics
NPI:1447258561
Name:SAMALE, GIRO RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:GIRO
Middle Name:RICHARD
Last Name:SAMALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:PROF
Other - First Name:RICHARD
Other - Middle Name:
Other - Last Name:SAMALE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 30
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230
Mailing Address - Country:US
Mailing Address - Phone:413-528-9311
Mailing Address - Fax:413-644-0274
Practice Address - Street 1:510 NORTH STREET
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201
Practice Address - Country:US
Practice Address - Phone:413-447-2351
Practice Address - Fax:413-445-7009
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME48291207Q00000X
MA150401207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL45193OtherBC/BS GROUP #
FL866091OtherUNITED HEALTH CARE #
FL2372318001OtherCIGNA
FL372213900Medicaid
FL372213900Medicaid
FL2372318001OtherCIGNA
FLD84636Medicare UPIN