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Individual

DR. JAMES C CUSACK

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
55 FRUIT ST, YAW 7B, BOSTON, MA 02114
(617) 724-4043
(617) 724-3895
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
74063
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0117781
MA
01
074063
TUFTS HEALTH PLAN
MA
01
J11385
BCBS MA
MA
Enumeration date
11/21/2005
Last updated
07/08/2007
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