Individual
DR. DEAN MICHAEL DONAHUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT STREET, BLK 1570, BOSTON, MA 02114-2696
(617) 724-0969
(617) 726-7667
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0969
(617) 726-7667
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
73115
MA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
73115
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3164071
—
MA
01
—
724821
TUFTS HEALTH PLAN
MA
01
—
J17268
BCBS MA
MA
Enumeration date
02/24/2006
Last updated
11/13/2012
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