Faller, Douglas V.
Faller, Douglas V. is an individual health care provider with primary practice located at 830 Harrison Ave Moakley, 3Rd Floor, Boston MA 02118-2905. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hematology. Allopathic & Osteopathic Physicians / Hematology is his primary health care specialty. Faller, Douglas V. can be contacted via phone (617) 638-6428.Contact Information
Primary practice address
830 Harrison Ave Moakley, 3Rd Floor
Boston MA 02118-2905
Phone: (617) 638-6428
Fax: (617) 638-5756
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 49947 | Massachusetts |
| Allopathic & Osteopathic Physicians / Hematology | 207RH0000X | 49947 | Massachusetts |
Profile Details
| NPI number | 1285699439 |
|---|---|
| LBN Legal business name | Faller, Douglas V. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 19th, 2006 |
| Last updated | May 9th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285699439 | NPPES |
| Massachusetts | MEDICAID | 110043569A | |
| Massachusetts | MEDICAID | 3012697 |
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