Provider Demographics
NPI:1023098621
Name:DOODY, DANIEL PATRICK (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:PATRICK
Last Name:DOODY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASSACHUSETTS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-726-2913
Mailing Address - Fax:617-726-2167
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:MASSACHUSETTS GENERAL HOSPITAL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-2913
Practice Address - Fax:617-726-2167
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2013-02-07
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Provider Licenses
StateLicense IDTaxonomies
MA58024174400000X, 208600000X, 2086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
No174400000XOther Service ProvidersSpecialist
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA713972OtherTUFTS HEALTH PLAN
MA3023257Medicaid
MAJ06339OtherBCBS MA
MAJ06339OtherBCBS MA
MAB98025Medicare UPIN