Individual
DR. ROBERT D FUSUNYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
40 2ND AVENUE, SUITE 340, WALTHAM, MA 02451-1132
(781) 466-8967
(781) 466-8987
Mailing address
44 NORTH STREET, LEXINGTON, MA 02420
(781) 862-1652
(781) 862-1652
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
78425
MA
2080P0206X
Pediatric Gastroenterology Physician
Primary
78425
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3159337
—
MA
01
—
750032
TUFTS HEALTH PLAN
MA
01
—
J17154
BCBS MA
MA
Enumeration date
11/02/2005
Last updated
09/03/2009
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