Organization
DAVID W. DOUGLAS, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANETTE DOUGLAS (PRACTICE MANAGER)
(781) 593-6005
Entity
Organization
Contact information
Practice address
330 LYNNWAY STE 109A, LYNN, MA 01901-1713
(781) 593-6005
(781) 593-6005
Mailing address
330 LYNNWAY STE 109A, LYNN, MA 01901-1713
(781) 593-6005
(781) 593-1370
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
150082
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110058501A
—
MA
01
—
1154340420
NPI - INDIVIDUAL
MA
Enumeration date
07/10/2017
Last updated
07/10/2017
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