Individual
MR. DAVID W DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
330 LYNNWAY, SUITE 109A, LYNN, MA 01901-1706
(781) 593-6005
(781) 593-1370
Mailing address
330 LYNNWAY, SUITE 109A, LYNN, MA 01901-1706
(781) 593-6005
(781) 593-1370
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
150082
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101449
UNITED HEALTHCARE
MA
01
—
150082
TUFTS HEALTH PLAN
MA
01
—
186207
HEALTHSOURCE
MA
01
—
2242081
AETNA US HEALTHCARE
MA
05
—
3166341
—
MA
01
—
710790
HARVARD PILGRIM
MA
01
—
B10347002
CIGNA
MA
01
—
J18455
BC/BS
MA
Enumeration date
07/18/2006
Last updated
07/08/2007
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