Provider Demographics
NPI:1962454298
Name:FARMER, DAVID MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:MICHAEL
Last Name:FARMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:D.
Other - Middle Name:MICHAEL
Other - Last Name:FARMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:300 MOUNT AUBURN ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-5600
Mailing Address - Country:US
Mailing Address - Phone:617-497-1560
Mailing Address - Fax:617-497-1109
Practice Address - Street 1:300 MOUNT AUBURN ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-5600
Practice Address - Country:US
Practice Address - Phone:617-497-1560
Practice Address - Fax:617-497-1109
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA221294207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA96478001OtherNETWORK HEALTH PLAN
MA0037770OtherNEIGHBORHOOD HEALTHPLAN
MA478911OtherTUFTS
MAAA55331OtherHARVARD PILGRIM HEALTHCARE
MA2097541Medicaid
MA1962454298OtherBOSTON MEDICAL CENTER HEALTH NET PLAN
MA115032OtherFALLON HEALTH PLAN
MA1200723OtherAETNA HEALTHCARE
MA9747674OtherCIGNA HEALTHPLAN
MA2097541Medicaid