Provider Demographics
NPI:1770573487
Name:DOYLE, PETER CHARLES (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:CHARLES
Last Name:DOYLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HOLLISTON
Mailing Address - State:MA
Mailing Address - Zip Code:01746-1819
Mailing Address - Country:US
Mailing Address - Phone:508-429-8060
Mailing Address - Fax:
Practice Address - Street 1:135 FORSYTH ST
Practice Address - Street 2:360 HUNTINGDON AVE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5024
Practice Address - Country:US
Practice Address - Phone:617-373-8922
Practice Address - Fax:617-373-2601
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA205029207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA205029OtherTUFTS
MA693112OtherHCHP
MA2023172Medicaid
MAM18068OtherBLUE CROSS
MAJ25306OtherBLUE CROSS
MD67275OtherCIGNA
MD67275OtherCIGNA
MA205029OtherTUFTS