Individual
DR. STEVEN MARSHALL STUFFLEBEAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT STREET FND2, RADIOLOGICAL ASSOCIATES, BOSTON, MA 02114-2696
(617) 726-0963
(617) 726-7422
Mailing address
PO 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-0963
(617) 726-7422
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
212768
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0191019
—
MA
01
—
212768
TUFTS HEALTH PLAN
MA
01
—
J24621
BCBS MA
MA
Enumeration date
12/02/2005
Last updated
08/09/2012
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