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Provider Information for 1225078397

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. DANIEL J HEDEQUIST MD

Gender: MALE

Individual NPI: 1225078397

Calendar   Last Updated:  2020-02-24
  Certification Date:  2020-02-24

Details

Name Value
NPI 1225078397
Enumeration Date 2006-06-07
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 300 LONGWOOD AVE
BOSTON, MA 02115-5724
United States

Phone: 617-461-3173 | Fax:
View Map External Link
Primary Practice Address 300 LONGWOOD AVE
BOSTON, MA 02115-5724
United States

Phone: 617-355-6021 | Fax: 617-730-0459
View Map External Link
Secondary Practice Address 1 MEDICAL CENTER DR
LEBANON, NH 03756-0001
United States

Phone: 603-650-5133 | Fax:
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Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID MA 0140899
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207X00000X - Orthopaedic Surgery MA 203238
No 207X00000X - Orthopaedic Surgery NH 20013