Individual
DR. DOUGLAS V. FALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
830 HARRISON AVE, MOAKLEY, 3RD FLOOR, BOSTON, MA 02118-2905
(617) 638-6428
(617) 638-5756
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
49947
MA
207RH0000X
Hematology (Internal Medicine) Physician
Primary
49947
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110043569A
—
MA
05
—
3012697
—
MA
Enumeration date
04/19/2006
Last updated
05/09/2014
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