Provider Demographics
NPI:1568449403
Name:JUDGE, DAVID C (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:JUDGE
Suffix:
Gender:M
Credentials:MD
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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:617-724-1100
Mailing Address - Fax:617-643-8898
Practice Address - Street 1:101 MERRIMAC ST STE 1000
Practice Address - Street 2:AMBULATORY PRACTICE OF THE FUTURE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-4773
Practice Address - Country:US
Practice Address - Phone:617-724-1100
Practice Address - Fax:617-643-8898
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2014-02-07
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Provider Licenses
StateLicense IDTaxonomies
MA158258207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA158258OtherTUFTS HEALTH PLAN
MAJ21266OtherBCBS MA
MA3195988Medicaid
MA3195988Medicaid
MAJ21266OtherBCBS MA