Provider Demographics
NPI:1073597910
Name:PINCUS, DAVID FRANK (MD, PHD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:FRANK
Last Name:PINCUS
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Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS. GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:1493 CAMBRIDGE ST
Practice Address - Street 2:CAMBRIDGE HOSPITAL
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-1047
Practice Address - Country:US
Practice Address - Phone:617-665-1630
Practice Address - Fax:617-665-1091
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-05
Last Update Date:2007-11-08
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Provider Licenses
StateLicense IDTaxonomies
MA52368207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3017656Medicaid
MA052368OtherTUFTS HEALTH PLAN
MAJ06693OtherBCBS MA
MA3017656Medicaid
MAJ06693Medicare PIN