Healthcare Provider Details

I. General information

NPI: 1609487834
Provider Name (Legal Business Name): DSMD CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2020
Last Update Date: 08/14/2020
Certification Date: 08/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 MICHELLE DR
BURLINGTON MA
01803-4510
US

IV. Provider business mailing address

7 MICHELLE DR
BURLINGTON MA
01803-4510
US

V. Phone/Fax

Practice location:
  • Phone: 617-340-9559
  • Fax:
Mailing address:
  • Phone: 617-340-9559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL ERIC WOLLMAN
Title or Position: MEMBER
Credential: MD, PHD
Phone: 617-340-9559