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Individual

DAVID L. COULTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
300 LONGWOOD AVE, FEGAN 11, BOSTON, MA 02115-5724
(617) 355-2758
(617) 730-0285
Mailing address
300 LONGWOOD AVE, FEGAN 11, BOSTON, MA 02115-5724
(617) 355-2758
(617) 730-0285

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
55654
MA
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
55654
MA

Other

Enumeration date
07/11/2006
Last updated
09/05/2007
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