Individual
DR. ANTHONY JOHN ROUSOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 MEDICAL CENTER DR STE 512, SPRINGFIELD, MA 01107-1273
(413) 794-5550
(413) 794-4212
Mailing address
280 CHESTNUT ST FL 2, SPRINGFIELD, MA 01199-1001
(413) 794-5700
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
213069
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01618941
BC/BS
IL
05
—
036123501
—
IL
05
—
1871777102
—
WI
05
—
201019550B
—
IN
Enumeration date
12/21/2007
Last updated
11/26/2021
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