Individual
DR. NISHAN G GOUDSOUZIAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, CLN 309, BOSTON, MA 02114-2621
(617) 724-0341
(617) 726-7536
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
31322
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031322
TUFTS HEALTH PLAN
MA
05
—
6175708
—
MA
01
—
J02404
BCBS MA
MA
Enumeration date
10/28/2005
Last updated
07/08/2007
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