David W. Douglas, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

150082 Issued in MA

Legal business name

DAVID W. DOUGLAS, MD

Practice address

330 Lynnway Ste 109a
Lynn, MA 01901-1713

Phone

(781) 593-6005

Fax

(781) 593-6005

NPI assigned

Jul 10, 2017

Last updated

Jul 10, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Janette Douglas

Title

Practice Manager

Phone

(781) 593-6005

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David W Douglas, MD

  • Family Medicine Physician
  • Lynn, MA
  • NPI 1154340420
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499644800000",
    "number": "1851813034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 LYNNWAY STE 109A",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011713",
            "telephone_number": "781-593-6005",
            "fax_number": "781-593-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 LYNNWAY STE 109A",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011713",
            "telephone_number": "781-593-6005",
            "fax_number": "781-593-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID W. DOUGLAS, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-10",
        "last_updated": "2017-07-10",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "JANETTE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "781-593-6005",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "150082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110058501A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI - INDIVIDUAL",
            "identifier": "1154340420",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nelli Danilyuk
• Lauren Irene Daponta, RN
• Ernesto Dasilva, MD
• Kelly L Daugherty, LMHC
• David Eagan PC (Broadway Chiropractic)
• Dorothy Davies, LICSW
• Davis Square Dental Specialists (T Station Dental of Lynn)
• Amanda Davis, CNM
• Elizabeth Shea Davis, LICSW
• Evemarie Tol Davis, M.ED OF DEAF

• Family Medicine Physician in Lynn, MA
• Providers in Lynn, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.