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Individual

DR. LOUIS GEORGE DUSSEAULT JR.

Active
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Individual

DR. LOUIS GEORGE DUSSEAULT JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
56357
MA
207R00000X
Internal Medicine Physician
Primary
ME139426
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102793800
—
FL
01
—
WATVX
BCBS
FL
Enumeration date
06/01/2005
Last updated
08/13/2019
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