Provider Demographics
NPI:1659443430
Name:DOPPELT, SAMUEL H (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:H
Last Name:DOPPELT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1493 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-1047
Mailing Address - Country:US
Mailing Address - Phone:617-665-1566
Mailing Address - Fax:
Practice Address - Street 1:1493 CAMBRIDGE ST
Practice Address - Street 2:1ST FLOOR CAMBRIDGE HOSPITAL ORTHOPAEDICS
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-1047
Practice Address - Country:US
Practice Address - Phone:616-766-5156
Practice Address - Fax:617-726-8522
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA42986207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA702039OtherTUFTS HEALTH PLAN
MA2067749Medicaid
MAM09894OtherBCBS MA
MAM09894OtherBCBS MA
MA2067749Medicaid