Individual
DR. EDWARD MICHAEL DUSSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
736 CAMBRIDGE ST, BRIGHTON, MA 02135-2907
(617) 789-3000
Mailing address
960 MASSACHUSETTS AVENUE, FL 2, BOSTON, MA 02118-2690
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
1016197
MA
208600000X
Surgery Physician
276408
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110150184A
—
MA
Enumeration date
06/19/2018
Last updated
07/22/2025
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