Healthcare Provider Details

I. General information

NPI: 1235163395
Provider Name (Legal Business Name): DUTTON FAMILY CARE ASSOCIATES LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 04/13/2021
Certification Date: 04/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 AVON ST
WAKEFIELD MA
01880-2310
US

IV. Provider business mailing address

33 AVON ST
WAKEFIELD MA
01880-2310
US

V. Phone/Fax

Practice location:
  • Phone: 781-245-0402
  • Fax: 781-246-0847
Mailing address:
  • Phone: 781-245-0402
  • Fax: 781-246-0847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number40277
License Number StateMA

VIII. Authorized Official

Name: DAVID A CALEF
Title or Position: SOLE PROPRIETOR
Credential: MD
Phone: 781-245-0402