Provider Demographics
NPI:1275571499
Name:LOTUFO, DAVID G (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:G
Last Name:LOTUFO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1900 CROWN COLONY DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-0979
Mailing Address - Country:US
Mailing Address - Phone:617-472-5242
Mailing Address - Fax:617-471-5093
Practice Address - Street 1:1900 CROWN COLONY DR
Practice Address - Street 2:SUITE 301
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-0979
Practice Address - Country:US
Practice Address - Phone:617-472-5242
Practice Address - Fax:617-471-5093
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2011-03-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA71420207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3077187Medicaid
MA3077187Medicaid