Individual
DR. CHARLES DUSSAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
75 FRANCIS ST, BOSTON, MA 02115-6110
(617) 732-5500
Mailing address
20 CHAPEL ST APT A803, BROOKLINE, MA 02446-7412
(617) 586-5415
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
261433
MA
Other
Enumeration date
02/08/2015
Last updated
02/08/2015
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