Doctor Name: | DAVID MARC BLAUSTEIN |
NPI Number: | 1104811900 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 78218 |
Business Practice Address: | 541 Main St Weymouth, MA - 021901868 |
Business Phone Number: | 7816829700 |
Business Fax Number: | 7816829660 |
Mailing Address: | 102 Birds Hill Ave, NEEDHAM |
State: | MA |
Postal Code: | 024924242 |
Phone Number: | 7814447386 |
Fax Number: | |
NPI Enumeration Date: | 09/18/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204C00000X |
License Number: | 78218 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Neuromusculoskeletal Medicine, Sports Medicine |
Taxonomy Specialization: | |
Taxonomy Definition: |