Provider Demographics
NPI:1770619363
Name:DOUMAS, ALEXANDER (MD)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:DOUMAS
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 1:75 HERRICK ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-5903
Mailing Address - Country:US
Mailing Address - Phone:978-927-8400
Mailing Address - Fax:
Practice Address - Street 1:75 HERRICK ST
Practice Address - Street 2:SUITE 206
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-5903
Practice Address - Country:US
Practice Address - Phone:978-927-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227196207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease