Provider Demographics
NPI:1497734768
Name:DUCOMB, LAURENCE EVANS (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:EVANS
Last Name:DUCOMB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:63 BRETTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-2305
Mailing Address - Country:US
Mailing Address - Phone:617-390-1410
Mailing Address - Fax:617-390-1584
Practice Address - Street 1:49 ROBINWOOD AVE
Practice Address - Street 2:THE ARBOUR HOSPITAL
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130
Practice Address - Country:US
Practice Address - Phone:617-390-1410
Practice Address - Fax:617-390-1595
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2015-12-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA435882084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA712373OtherTUFTS HEALTH PLAN
MAB07169OtherBCBS MA
MA3011755Medicaid
MAB07169OtherBCBS MA
MA3011755Medicaid