Provider Demographics
NPI:1861453573
Name:SEGALL, FRANKLIN DORIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:DORIAN
Last Name:SEGALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ALONESOS WAY
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-4634
Mailing Address - Country:US
Mailing Address - Phone:978-470-2271
Mailing Address - Fax:617-864-1507
Practice Address - Street 1:10 ALONESOS WAY
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810
Practice Address - Country:US
Practice Address - Phone:978-470-2271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA45214207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0138819Medicaid
MAB11706Medicare ID - Type Unspecified
MA0138819Medicaid