Provider Demographics
NPI:1689673980
Name:PUTNOI, DONALD WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:WILLIAM
Last Name:PUTNOI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:20 HOPE AVE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-2721
Mailing Address - Country:US
Mailing Address - Phone:781-894-2020
Mailing Address - Fax:781-891-7936
Practice Address - Street 1:20 HOPE AVE
Practice Address - Street 2:SUITE 212
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-2721
Practice Address - Country:US
Practice Address - Phone:781-891-1447
Practice Address - Fax:781-891-7936
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2014-01-30
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Provider Licenses
StateLicense IDTaxonomies
MA32609207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB33295OtherBLUE CROSS BLUE SHIELD
MA15243OtherHARVARD PILGRIM HEALTH
MA97747OtherUS HEALTHCARE
MA25543OtherFALLON HEALTH CARE
MA0006372OtherNEIGHBORHOOD HEALTH PLAN
MA820000272OtherRAILROAD MEDICARE
MA032609OtherTUFTS HEALTH PLAN
MA2024195Medicaid
MAB20255601OtherCIGNA HEALTHCARE
MA08-00281OtherUNITED HEALTHCARE
MAA35903Medicare UPIN
MA032609OtherTUFTS HEALTH PLAN