Individual
DR. W SCOTT MCDOUGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT STREET GRB1102, DEPARTMENT OF UROLOGY, BOSTON, MA 02114
(617) 726-4530
(617) 726-6131
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-4530
(617) 726-6131
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
73400
MA
208800000X
Urology Physician
Primary
73400
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
073400
TUFTS HEALTH PLAN
MA
05
—
3070794
—
MA
01
—
J10422
BCBS MA
MA
Enumeration date
10/27/2005
Last updated
08/16/2012
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