Provider Demographics
NPI:1134203276
Name:PURCELL, DAGMARY (MD)
Entity type:Individual
Prefix:
First Name:DAGMARY
Middle Name:
Last Name:PURCELL
Suffix:
Gender:F
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:COND. PASEOS DEL ROCIO
Mailing Address - Street 2:APART 308
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-467-5812
Mailing Address - Fax:
Practice Address - Street 1:CALLE FORT MARTELO #355
Practice Address - Street 2:HOSPITAL RYDER, SUITE 509
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00972-0000
Practice Address - Country:US
Practice Address - Phone:787-656-0758
Practice Address - Fax:787-656-0758
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15902207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology