Individual
SAMUEL P DONEGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
830 OAK STREET, SUITE 223E, BROCKTON, MA 02301
(508) 427-2222
(508) 897-4773
Mailing address
960 MASSACHUSETTS AVENUE, FL 2, BALTIMORE, MA 02118-2690
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
56194
MA
207V00000X
Obstetrics & Gynecology Physician
D0068818
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022452900
—
MD
05
—
110043227A
—
MA
01
—
152599ZEZT
MEDICARE PTAN
MD
01
—
165767
MEDICARE GROUP PTAN
MD
01
—
950201
CAREFIRST RENDERING NUMBER
MD
01
—
Q818-0019
CAREFIRST
—
Enumeration date
08/12/2005
Last updated
03/10/2025
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