Individual
DR. CHRISTOS A ATHANASOULIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, GRB 2, BOSTON, MA 02114-2696
(617) 726-8319
(617) 726-8476
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
32803
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
032803
TUFTS HEALTH PLAN
MA
05
—
2085127
—
MA
01
—
M08036
BCBS MA
MA
Enumeration date
11/02/2005
Last updated
07/08/2007
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