Provider Demographics
NPI:1487717179
Name:NATHAN, DAVID G (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:G
Last Name:NATHAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:44 BINNEY STREET
Mailing Address - Street 2:SUITE 1644 DANA FARBER CANCER INSTITUTE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-632-2155
Mailing Address - Fax:617-632-6585
Practice Address - Street 1:44 BINNEY ST
Practice Address - Street 2:SUITE 1644, DANA FARBER CNACER INSTITUTE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6013
Practice Address - Country:US
Practice Address - Phone:617-632-2155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA257432080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
4148557OtherCIGNA
694501OtherHPHC DFCI ONLY
2066634OtherAETNA US HEALTHCARE
1101614959OtherRR MEDICARE DFCI
23306OtherFALLON COMMUNITY HEALTH
025743OtherTUFTS
MAM04031OtherBLUE CROSS BLUE SHIELD
2066634OtherAETNA US HEALTHCARE
MAM04031OtherBLUE CROSS BLUE SHIELD