Provider Demographics
NPI:1073574042
Name:COLDEN, DARYL G (MD)
Entity Type:Individual
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First Name:DARYL
Middle Name:G
Last Name:COLDEN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1 WALLACE BASHAW JR WAY
Mailing Address - Street 2:STE 3002
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950
Mailing Address - Country:US
Mailing Address - Phone:978-997-1550
Mailing Address - Fax:978-997-1552
Practice Address - Street 1:1 WALLACE BASHAW JR WAY
Practice Address - Street 2:STE 3002
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950
Practice Address - Country:US
Practice Address - Phone:978-997-1550
Practice Address - Fax:978-997-1552
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-30
Last Update Date:2018-02-19
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Provider Licenses
StateLicense IDTaxonomies
MA208834207YX0905X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ24800OtherBLUE CROSS BLUE SHIELD
NV01Y003843MA03OtherANTHEM NH
NH30204061Medicaid
MA9785370Medicaid
MAP00460150OtherRAILROAD MEDICARE
MA59186OtherFALLON COMMUNITY HEALTH
MA0026698OtherNEIGHBORHOOD HEALTH
MA3143490OtherCIGNA
MA3391910OtherAETNA
MA10-00490OtherEVERCARE
MA19950OtherHARVARD PILGRIM
MA208834OtherTUFTS HEALTH PLAN
MD1000458OtherUNITED HEALTHCARE
MA97625305OtherNETWORK HEALTH
MAA3392101Medicare PIN
MAA33921Medicare PIN
MAH25975Medicare UPIN