Provider Demographics
NPI:1609843598
Name:MCDONAGH, JOAN M (MD)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:M
Last Name:MCDONAGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605
Mailing Address - Country:US
Mailing Address - Phone:508-898-2338
Mailing Address - Fax:508-366-9938
Practice Address - Street 1:900 UNION ST
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-5408
Practice Address - Country:US
Practice Address - Phone:508-898-2338
Practice Address - Fax:508-366-9938
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA156420208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
33750OtherFALLON COMMUNITY HEALTH P
J19162OtherBLUE SHIELD IDEMNITY
784160OtherMVP HEALTH CARE
MA110059991AMedicaid
37276OtherCHILDRENS MEDICAL SECURIT
AA1258OtherHARVARD PILGRIM HEALTHCAR
8681031OtherCIGNA HEALTH PLAN
042472266OtherTHREE RIVERS
042472266OtherTRICARE CHAMPUS
3181740OtherHEALTHY START
7689513OtherAETNA US HEALTHCARE
A28407OtherMEDICARE B
J19162OtherBLUE SHIELD HMO BLUE
042472266OtherHEALTHCARE VALUE MANAGEME
042472266OtherONE HEALTH PLAN
2039844OtherFIRST HEALTH
042472266OtherPRIVATE HEALTHCARE SYSTEM
J19162OtherBLUE CARE ELECT
37276OtherCHILDRENS MEDICAL SECURIT
8681031OtherCIGNA HEALTH PLAN