Individual
MR. TONY MICHAEL MASUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25 RIDGEWOOD ROAD, SPRINGFIELD, VT 05156-2003
(802) 885-7691
(802) 885-7698
Mailing address
868 BIXBY ROAD, EAST WALLINGFORD, VT 05742-9640
(802) 259-3490
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
0420009122
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OVN1209
—
VT
Enumeration date
07/25/2006
Last updated
07/08/2007
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