Individual
DOUGLAS A MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MASSACHUSETTS GENERAL HOSPITAL, 55 FRUIT STREET, BOSTON, MA 02114
(617) 726-2800
Mailing address
375 BOYLSTON STREET, BWH BWPO PROVIDER SERVICES, BROOKLINE, MA 02445-6007
(857) 307-0866
(617) 394-3209
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
L-260310
MA
Other
Enumeration date
06/06/2014
Last updated
07/22/2015
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