MEDICARE: RAMONA DVORAK 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	2084P0800X	Psychiatry Physician	56861	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	759563	OTHER	TUFT'S PROVIDER NUMBER
2	283134	OTHER	MAGELLAN OUT OF NETWORK #
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386635589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAMONA DVORAK M.D.

Provider Business Mailing Address
First Line	:	1 JOSLIN PL
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02215-5306
Country	:	US
Telephone Number	:	617-309-2400
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 JOSLIN PL
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02215-5306
Country	:	US
Telephone Number	:	617-309-2400
Fax Number	:

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

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	02/03/2015

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Directions to “ RAMONA DVORAK M.D.” Practice Location

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