Provider Demographics
NPI:1851330682
Name:BURD, DOUGLAS A (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:A
Last Name:BURD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 1045
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01613-1045
Mailing Address - Country:US
Mailing Address - Phone:978-939-2035
Mailing Address - Fax:978-939-2039
Practice Address - Street 1:14 RICE RD
Practice Address - Street 2:
Practice Address - City:TEMPLETON
Practice Address - State:MA
Practice Address - Zip Code:01468-1332
Practice Address - Country:US
Practice Address - Phone:978-939-2035
Practice Address - Fax:978-939-2039
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA728772085N0700X
MA0728772085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
29565OtherFALLON COMMUNITY HEALTH PLAN
MA3063984Medicaid
750009OtherTUFTS HEALTH PLAN
J09749OtherBLUE CROSS BLUE SHIELD
MA99931305OtherNETWORK HEALTH
0007041OtherNEIGHBORHOOD HEALTH PLAN
MA3063984OtherHEALTHY START
AA92251OtherHARVARD PILGRIM HEALTH CARE
40004OtherHEALTH NEW ENGLAND
MA3063984OtherHEALTHY START
750009OtherTUFTS HEALTH PLAN