Provider Demographics
NPI:1851566780
Name:TRUTT, DANIEL (MD,CM)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:TRUTT
Suffix:
Gender:M
Credentials:MD,CM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 PARADISE RD
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-2948
Mailing Address - Country:US
Mailing Address - Phone:781-596-2000
Mailing Address - Fax:
Practice Address - Street 1:369 HARVARD ST
Practice Address - Street 2:APARTMENT #3
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-2910
Practice Address - Country:US
Practice Address - Phone:617-879-9808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA225767207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine