MEDICARE: DOUGLAS BURTON ATKINSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP3000X	Pediatric Anesthesiology Physician	252121	MA
2	2080P0203X	Pediatric Critical Care Medicine Physician	252121	MA

General Provider Information

NPI Number	:	1821145772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS BURTON ATKINSON MD

Provider Business Mailing Address
First Line	:	300 LONGWOOD AVE
Second Line	:	BCH, DEPT OF ANESTHESIOLOGY
City	:	BOSTON
State	:	MA
Zip	:	02115-5724
Country	:	US
Telephone Number	:	617-355-8173
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 LONGWOOD AVE
Second Line	:	BCH, DEPT OF ANESTHESIOLOGY
City	:	BOSTON
State	:	MA
Zip	:	02115-5724
Country	:	US
Telephone Number	:	617-355-8173
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	06/06/2014

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