MEDICARE: RACHEL DONNELLY M.D.

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	207Q00000X	Family Medicine Physician	156136	MA

General Provider Information

NPI Number	:	1235207440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL DONNELLY M.D.

Provider Business Mailing Address
First Line	:	31 GREEN ST
Second Line	:
City	:	MEDFIELD
State	:	MA
Zip	:	02052-1715
Country	:	US
Telephone Number	:	508-359-5471
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 ELM ST STE 220
Second Line	:
City	:	DEDHAM
State	:	MA
Zip	:	02026-4530
Country	:	US
Telephone Number	:	508-746-2000
Fax Number	:

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

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	05/31/2019

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