Provider Demographics
NPI:1235135781
Name:SCHURGIN, DAVID J (OD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:SCHURGIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 PARK ST
Mailing Address - Street 2:APT C5
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-2758
Mailing Address - Country:US
Mailing Address - Phone:781-438-8407
Mailing Address - Fax:
Practice Address - Street 1:224 PARK ST
Practice Address - Street 2:APT C5
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-2758
Practice Address - Country:US
Practice Address - Phone:781-438-8407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-21
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2345T152W00000X, 152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00112641OtherRR MEDICARE
MAW15232OtherBLUE CROSS BLUE SHIELD
MA0395072Medicaid
001333518OtherHIGHMARK BCBS
MA151581OtherHARVARD/PILGRIMHEALTHCARE
3236433OtherAETNA
MAW15232OtherBLUE CROSS BLUE SHIELD
T59160Medicare UPIN