Provider Demographics
NPI:1043275613
Name:MOODY, DAVID BRANCH (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:BRANCH
Last Name:MOODY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:111 CYPRESS ST
Mailing Address - Street 2:BRIGHAM AND WOMENS PHYSICIANS ORGANIZATION
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02445
Mailing Address - Country:US
Mailing Address - Phone:857-307-0896
Mailing Address - Fax:
Practice Address - Street 1:ARTHIRITIS CENTER 75 FRANCIS ST
Practice Address - Street 2:BWH RHEUMATOLOGY IMMUNOLOGY AND ALLERGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-732-5235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA79861207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology