Dr. Mark David Dexter
Pediatric Critical Care Doctor
800 Washington St
Boston
, Massachusetts 02111-1552
Dr. Mark David Dexter
Pediatric Critical Care Doctor
800 Washington St
Boston
, Massachusetts 02111-1552
(617) 636-5000
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About
Features
Specialties
- Pediatric Critical Care Doctor
Languages spoken
- English
Location
First Address
- Dr. Mark David Dexter
- Po Box 28302
- New York, NY
- Zip : 10087-8302
- Phone : (617) 636-5000
Second Address
- Dr. Mark David Dexter
- 800 Washington St
- Boston, MA
- Zip : 02111-1552
- Fax : (617) 636-8391
- Phone : (617) 636-8100
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0203X | Pediatric Critical Care Doctor | 2014-00363 | NC |
National Provider Identifier
| NPI | 1033408513 |
|---|---|
| Provider Name | Dr. Mark David Dexter |
| First Address | New York, NY 10087-8302 |
| Second Address | Boston, MA 02111-1552 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/04/2011 |
| Last Update Date | 17/04/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1033408513 | (05) | NC |
| 110158942A | (05) | MA |
| 19R6T | BCBS OF NC (01) | NC |
| 2014-00363 | LICENSE (01) | NC |
| 281842 | MA MEDICAL LICENSE (01) | MA |
| NCY4470322 | MEDICARE (01) | NC |
| S400622433 | MEDICARE (01) | MA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.