Provider Demographics
NPI:1194811315
Name:NEPTUNE-HAMMOND, DOREEN (MD)
Entity type:Individual
Prefix:
First Name:DOREEN
Middle Name:
Last Name:NEPTUNE-HAMMOND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 CITY HALL MALL
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-4754
Mailing Address - Country:US
Mailing Address - Phone:781-306-5304
Mailing Address - Fax:781-306-5227
Practice Address - Street 1:26 CITY HALL MALL
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-4754
Practice Address - Country:US
Practice Address - Phone:781-306-5304
Practice Address - Fax:781-306-5227
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA50638207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAG181OtherHARVARD PILGRIM
MA0014781OtherNEIGHBORHOOD HEALTH PLAN
MAJ03772OtherBLUE CROSS
MA5855898-002OtherCIGNA HEALTH CARE
MA3178935Medicaid
MA737825OtherTUFTS
MAA29593Medicare PIN