Provider Demographics
NPI:1194915280
Name:MCBRINE, JOSEPH V (DO)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:V
Last Name:MCBRINE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:519 COLUMBUS AVE
Mailing Address - Street 2:#3
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-3433
Mailing Address - Country:US
Mailing Address - Phone:617-638-6950
Mailing Address - Fax:
Practice Address - Street 1:BOSTON MEDICAL CENTER, DEPARTMENT OF ANE
Practice Address - Street 2:ONE BOSTON MEDICAL CENTER PLACE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-638-6950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA233726207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2159139Medicaid
MA000724601Medicare PIN