MEDICARE: MERRIEBETH DODGE DO

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	220282	MA
2	207R00000X	Internal Medicine Physician	220282	MA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00131174	OTHER	MA	RAILROAD MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	J27382	OTHER	MA	BCBS
2	34098	OTHER	MA	HEALTH NEW ENGLAND
3	10083969	OTHER	MA	CAPITAL PHYSICIANS HEALTH
4	6298964	OTHER	MA	CIGNA INDEMNITY
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	469003	OTHER	MA	TUFTS
8	781262	OTHER	MA	MVP
9	AA19492	OTHER	MA	HARVARD
10	000000028288	OTHER	MA	HEALTHNET
11	043531502	OTHER	MA	GIC INDEMNITY

NPI Number	:	1801857933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERRIEBETH DODGE DO

Provider Business Mailing Address
First Line	:	1HOSPTAL ROAD
Second Line	:
City	:	OAK BLUFFS
State	:	MA
Zip	:	02557-1477
Country	:	US
Telephone Number	:	508-693-3164
Fax Number	:	508-696-5238

Provider Business Practice Location Address
First Line	:	1 HOSPTAL ROAD
Second Line	:
City	:	OAK BLUFFS
State	:	MA
Zip	:	02557-1477
Country	:	US
Telephone Number	:	508-693-3164
Fax Number	:	508-696-5238

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

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	01/21/2025

ONE HOSPITAL RD
OAK BLUFFS, MA
02557-1477

Practice Phone: 508-693-0410
Practice Fax: 508-696-8474