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Contact Information

DOUGLAS J MATHISEN, MD
55 FRUIT STREET
BLK 1570 THORACIC SURGERY DEPARTMENT
BOSTON, MA02114-2696
 Phone: 617-726-6826
 Fax: 617-726-7667
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Thoracic Surgery (Cardiothoracic Vascular Surgery)

208G00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for DOUGLAS J MATHISEN · (Male)

NPI Number 1699759019
Status Active
Credentials MD
Entity Individual
Enumeration date 11/30/2005
Last updated 11/21/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • MA License # 39784
  • MA Medicaid 0182656
  • MA Other E05949 BCBS MA
  • MA Other 710067 TUFTS HEALTH PLAN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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