Individual
DR. RALPH WEISSLEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
55 FRUIT ST, ELL 2, BOSTON, MA 02114-2696
(617) 726-8396
(617) 726-4891
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 726-8226
(617) 643-6133
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
77481
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
077481
TUFTS HEALTH PLAN
MA
05
—
3112462
—
MA
01
—
J30073
BCBS MA
MA
Enumeration date
10/31/2005
Last updated
08/09/2012
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