Individual
DR. PHILIP MICHAEL DUSSAULT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
251 CAUSEWAY ST, BOSTON, MA 02114-2148
(617) 248-1290
Mailing address
251 CAUSEWAY ST, BOSTON, MA 02114-2148
(617) 248-1470
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
21111
MA
1835P1200X
Pharmacotherapy Pharmacist
21111
MA
Other
Enumeration date
07/18/2006
Last updated
04/18/2016
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