Individual
DOUGLAS S FISHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-7953
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8053
(617) 421-3487
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
220952
MA
2080P0206X
Pediatric Gastroenterology Physician
Primary
220952
MA
2080P0206X
Pediatric Gastroenterology Physician
M5159
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0033602
NEIGHBORHOOD HEALTH
MA
05
—
2091895
—
MA
01
—
469569
TUFTS
MA
01
—
6821914
CIGNA
MA
01
—
AA16675
HARVARD PILGRIM
MA
01
—
J27952
BLUE CROSS
MA
Enumeration date
04/19/2006
Last updated
03/08/2023
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