Individual
L. DOUGLAS DOLGOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20 GUEST ST STE 225, BRIGHTON, MA 02135-2065
(617) 738-8642
(617) 202-4172
Mailing address
20 GUEST ST STE 225, BRIGHTON, MA 02135-2065
(617) 738-8642
(617) 202-4172
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
71000
MA
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
71000
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
137530
CIGNA
MA
01
—
2437395
AETNA
MA
01
—
2916
FALLON COMM. HEALTH PLAN
MA
05
—
3082750
—
MA
01
—
720652
TUFTS HEALTH PLAN
MA
01
—
80575
HARVARD PILGRIM
MA
01
—
J10312
BLUE CROSS BLUE SHIELD
MA
Enumeration date
02/27/2006
Last updated
12/06/2017
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