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Individual

DR. EDWARD JAMES BUSICK JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
20 HOPE AVENUE, SUITE 211, WALTHAM, MA 02453-2717
(781) 647-0855
(781) 647-9142
Mailing address
20 HOPE AVENUE, SUITE 211, WALTHAM, MA 02453-2717
(781) 647-0855
(781) 647-9142

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
40958
MA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
40958
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2052334
MA
01
M09465
BLUE CROSS/BLUE SHIELD
Enumeration date
11/30/2005
Last updated
02/22/2012
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