Provider Demographics
NPI:1427001197
Name:HALPORN, JOHN D (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:HALPORN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:450 BROOKLINE AVE
Mailing Address - Street 2:DANA - 2, POPC
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5418
Mailing Address - Country:US
Mailing Address - Phone:617-632-6464
Mailing Address - Fax:617-632-6180
Practice Address - Street 1:450 BROOKLINE AVE
Practice Address - Street 2:DANA - 2, POPC
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5418
Practice Address - Country:US
Practice Address - Phone:617-632-6464
Practice Address - Fax:617-632-6180
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA151005207R00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00278201OtherMEDICARE RAILROAD
MA5341530OtherAETNA
MA0131547Medicaid
014523OtherTUFTS HEALTH PLAN
MA6000260 OR AA98338OtherHARVARD PILGRIM
MA1427001197OtherNHP
MA1507407OtherCIGNA
MA54745OtherFALLON
MA97161802OtherNETWORK HEALTH
MAJ23531OtherBCBS MA
MA0131547Medicaid
MAA32519Medicare ID - Type Unspecified
MA5341530OtherAETNA