IndividualActive
Douglas Mathisen, MD
NPI 1699759019 · Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · Boston, MA
Provider details
- NPI number
- 1699759019
- Entity type
- Individual
- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 39784 (MA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
55 Fruit Street
Blk 1570 Thoracic Surgery Department
Boston, MA 02114-2696
Phone: (617) 726-6826
Fax: (617) 726-7667
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 9142
Charlestown, MA 02129-9142
Registry dates
- Enumerated
- 2005-11-30
- Last updated
- 2012-11-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.