Provider Demographics
NPI:1477581437
Name:MASON, MICHAEL DOYLE (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DOYLE
Last Name:MASON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:20 GUEST ST
Mailing Address - Street 2:SUITE 225
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2040
Mailing Address - Country:US
Mailing Address - Phone:617-738-8642
Mailing Address - Fax:617-491-2552
Practice Address - Street 1:20 GUEST ST
Practice Address - Street 2:SUITE 225
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2040
Practice Address - Country:US
Practice Address - Phone:617-738-8642
Practice Address - Fax:617-491-2552
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2017-12-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA80434207X00000X, 207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1477581437Medicare NSC
MAE65190Medicare UPIN
MA1477581437Medicare NSC