Individual
DAVID S TITELBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
265 WESTGATE DR, BROCKTON, MA 02301-1817
(800) 258-4674
(508) 897-3198
Mailing address
265 WESTGATE DR, BROCKTON, MA 02301-1817
(800) 258-4674
(508) 897-3198
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
54043
MA
2085R0202X
Diagnostic Radiology Physician
3585828
OH
2085R0202X
Diagnostic Radiology Physician
Primary
54043
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3045951
—
MA
01
—
J08231
BLUE CROSS BLUE SHIELD
MA
Enumeration date
07/06/2005
Last updated
12/12/2017
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