Organization
DIGESTIVE DISEASE ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN M RUSSO MD (PRESIDENT)
(508) 747-1560
Entity
Organization
Contact information
Practice address
47 OBERY ST, STE 201, PLYMOUTH, MA 02360-2230
(508) 747-1560
(508) 747-5155
Mailing address
47 OBERY ST, STE 201, PLYMOUTH, MA 02360
(508) 747-1560
(508) 747-5155
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3020835
—
MA
Enumeration date
01/29/2008
Last updated
11/15/2016
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