Provider Demographics
NPI:1619954757
Name:DUNAL, JUDY A (MD)
Entity Type:Individual
Prefix:DR
First Name:JUDY
Middle Name:A
Last Name:DUNAL
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 1:1221 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1561
Mailing Address - Country:US
Mailing Address - Phone:781-340-1702
Mailing Address - Fax:781-340-0931
Practice Address - Street 1:1221 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1561
Practice Address - Country:US
Practice Address - Phone:781-340-1702
Practice Address - Fax:781-340-0931
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA72222207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA072222OtherTUFTS HEALTH PLAN
MA3064891Medicaid
MA60762OtherHARVARD PILGRIM
MAJ09648OtherBLUE CROSS BLUE SHIELD
MAJ09648Medicare PIN
MA60762OtherHARVARD PILGRIM