Individual
DR. MATTHEW MOSSANEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 726-8078
Mailing address
665 WASHINGTON ST, APT 2413, BOSTON, MA 02111-1636
(818) 590-2441
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
266185
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2010
Last updated
07/02/2016
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