Provider Demographics
NPI:1740323112
Name:THE DOCTORS GROUP, INC
Entity type:Organization
Organization Name:THE DOCTORS GROUP, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-731-6333
Mailing Address - Street 1:1101 BEACON ST
Mailing Address - Street 2:SUITE 2 W
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5587
Mailing Address - Country:US
Mailing Address - Phone:617-731-6333
Mailing Address - Fax:617-566-1719
Practice Address - Street 1:1101 BEACON ST
Practice Address - Street 2:SUITE 2 W
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5587
Practice Address - Country:US
Practice Address - Phone:617-731-6333
Practice Address - Fax:617-566-1719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA37529207RG0100X
MA33833207RG0100X
MA36631207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9705538Medicaid
MAM 11 125Medicare ID - Type Unspecified