Individual
DR. MARK DAVID DEXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5737
(617) 355-6000
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5737
(617) 355-6000
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
281842
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110158942A
—
MA
01
—
281842
MA MEDICAL LICENSE
MA
01
—
S400622433
MEDICARE
MA
Enumeration date
04/05/2011
Last updated
04/05/2023
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