Provider Demographics
NPI:1134119852
Name:DOYLE MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:DOYLE MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-634-0017
Mailing Address - Street 1:5 WATER ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-4105
Mailing Address - Country:US
Mailing Address - Phone:508-634-0017
Mailing Address - Fax:508-478-6247
Practice Address - Street 1:5 WATER ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-4105
Practice Address - Country:US
Practice Address - Phone:508-634-0017
Practice Address - Fax:508-478-6247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA205029207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA205029OtherTUFTS
MA2023172Medicaid
MD693112OtherH.C.H.P
MA67275OtherCIGNA
MAJ25306OtherBLUE CROSS
MAM18068OtherBLUE CROSS
MA67275OtherCIGNA
MAH66407Medicare UPIN