Individual
DANA KAILANI FUGELSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1101 BEACON ST, SUITE 1W, BROOKLINE, MA 02446-5587
(617) 731-8334
Mailing address
1101 BEACON ST, SUITE 1W, BROOKLINE, MA 02446-5587
(617) 731-8334
(617) 731-8556
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
74545
MA
Other
Enumeration date
05/01/2006
Last updated
09/07/2007
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