Individual
DR. KEITH JAY DREYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO PHD
Contact information
Practice address
55 FRUIT ST, E00 3E RADIOLOGICAL ASSOCIATES, BOSTON, MA 02114-2696
(617) 724-1962
(617) 724-5597
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
79753
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3128504
—
MA
01
—
750053
TUFTS HEALTH PLAN
MA
01
—
J30723
BCBS MA
MA
Enumeration date
11/03/2005
Last updated
07/26/2012
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