Individual
DR. ROLAND R BRUSSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
CHILDREN'S HOSPITAL ANESTHESIA DEPARTMENT, 300 LONGWOOD AVENUE, BOSTON, MA 02115
(617) 355-2114
(617) 729-8923
Mailing address
CHILDREN'S HOSPITAL ANESTHESIA DEPARTMENT, 300 LONGWOOD AVENUE, BOSTON, MA 02115
(617) 355-2114
(617) 729-8923
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
225840
MA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
225840
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
478748
TUFTS HEALTH PLAN
MA
01
—
J29254
BCBS OF MA
MA
Enumeration date
10/26/2005
Last updated
05/20/2009
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