Individual
DR. DAVID MISCHOULON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
15 PARKMAN ST, MASSACHUSETTS GENERAL HOSPITAL, WAC-812, BOSTON, MA 02114-3117
(617) 724-5198
(617) 724-3028
Mailing address
40 VARNUM ST, ARLINGTON, MA 02474-8713
(781) 641-4458
(617) 724-3028
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
152539
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
152539
TUFTS
MA
05
—
3176991
—
MA
01
—
J18671
BCBS
MA
Enumeration date
09/26/2005
Last updated
07/09/2007
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