Organization
DANA K. FUGELSO, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANA K FUGELSO M.D. (PHYSICIAN OWNER)
(781) 731-8334
Entity
Organization
Contact information
Practice address
1101 BEACON ST, SUITE 1 WEST, BROOKLINE, MA 02446-5587
(781) 731-8334
(781) 731-8556
Mailing address
1101 BEACON ST, SUITE 1 WEST, BROOKLINE, MA 02446-5587
(781) 731-8334
(781) 731-8556
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
74545
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3133699
—
MA
Enumeration date
05/24/2007
Last updated
08/22/2020
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