Provider Demographics
NPI:1558336289
Name:FOXWORTHY, DONALD M (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:M
Last Name:FOXWORTHY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:637 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124-3510
Mailing Address - Country:US
Mailing Address - Phone:617-825-9660
Mailing Address - Fax:617-288-7898
Practice Address - Street 1:133 BROOKLINE AVE
Practice Address - Street 2:INTERNAL MEDICINE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-3904
Practice Address - Country:US
Practice Address - Phone:617-421-5804
Practice Address - Fax:617-421-8865
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2023-12-21
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Provider Licenses
StateLicense IDTaxonomies
MA53686207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA053686OtherTUFTS
MA3104290Medicaid
MAJ03548OtherBLUE CROSS
MAPM327OtherHARVARD PILGRIM
MA110052441AMedicaid
MA053686OtherTUFTS