MEDICARE: ALEXANDER D MACALALAD 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	207RI0200X	Infectious Disease Physician	212517	MA

General Provider Information

NPI Number	:	1245298207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER D MACALALAD M.D.

Provider Business Mailing Address
First Line	:	677 HUNTINGTON AVE
Second Line	:	HSPH-DEPT. OF BIOSTATISTICS
City	:	BOSTON
State	:	MA
Zip	:	02115-6028
Country	:	US
Telephone Number	:	617-432-1056
Fax Number	:

Provider Business Practice Location Address
First Line	:	677 HUNTINGTON AVE
Second Line	:	HSPH-DEPT. OF BIOSTATISTICS
City	:	BOSTON
State	:	MA
Zip	:	02115-6028
Country	:	US
Telephone Number	:	617-432-1056
Fax Number	:

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

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	07/08/2007

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