MEDICARE: DR. LENA EBBA DOHLMAN MD

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	207L00000X	Anesthesiology Physician	44278	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	044278	OTHER	MA	TUFTS HEALTH PLAN
3	J07027	OTHER	MA	BCBS MA

General Provider Information

NPI Number	:	1669462818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LENA EBBA DOHLMAN MD

Provider Business Mailing Address
First Line	:	1493 CAMBRIDGE ST
Second Line	:	CHA - ANESTHESIOLOGY
City	:	CAMBRIDGE
State	:	MA
Zip	:	02139-1047
Country	:	US
Telephone Number	:	617-499-6634
Fax Number	:

Provider Business Practice Location Address
First Line	:	1493 CAMBRIDGE ST
Second Line	:	CHA - ANESTHESIOLOGY
City	:	CAMBRIDGE
State	:	MA
Zip	:	02139-1047
Country	:	US
Telephone Number	:	617-499-6634
Fax Number	:

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

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	11/28/2007

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