Provider Demographics
NPI:1184730673
Name:DUPEE, RICHARD M (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:M
Last Name:DUPEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:800 WASHINGTON STREET
Mailing Address - Street 2:#327
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111
Mailing Address - Country:US
Mailing Address - Phone:617-636-2800
Mailing Address - Fax:617-636-3080
Practice Address - Street 1:800 WASHINGTON STREET
Practice Address - Street 2:#327
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111
Practice Address - Country:US
Practice Address - Phone:617-636-2800
Practice Address - Fax:617-636-3080
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA34539207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6569NEMCOtherHARVARD PILGRIM
MA2037017Medicaid
MA700439OtherTUFTS
MAB51035OtherBLUE CROSS BLUE SHIELD
MA112909170OtherRAILROAD MEDICARE
MA6569NEMCOtherHARVARD PILGRIM
MAB51035Medicare ID - Type Unspecified