Basic Information
| Provider Information | |||||||||
| NPI: | 1154307791 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AUGUST | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | A. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 55 FRUIT ST., GRB 444 | ||||||||
| Address2: | MASSACHUSETTS GENERAL HOSPITAL, DEPT. OF ANESTHESIA | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177263030 | ||||||||
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| Practice Location | |||||||||
| Address1: | 55 FRUIT ST., GRB 444 | ||||||||
| Address2: | MASSACHUSETTS GENERAL HOSPITAL, DEPT. OF ANESTHESIA | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177263030 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/15/2005 | ||||||||
| LastUpdateDate: | 06/29/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | A876800 | CA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP3000X | 216143 | MA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pediatric Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 009449 | 01 | CA | PHYSICIAN INDEX # | OTHER |