Individual
DR. GRACE JOHANNETTE MUSHRUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
940 BELMONT ST, BROCKTON, MA 02301-5596
(617) 244-7589
(617) 965-4142
Mailing address
940 BELMONT ST, BROCKTON, MA 02301-5596
(508) 583-4500
(774) 826-1859
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
35147
MA
2084P0015X
Psychosomatic Medicine Physician
35147
MA
2084P0800X
Psychiatry Physician
Primary
35147
MA
2084P0805X
Geriatric Psychiatry Physician
35147
MA
Other
Enumeration date
09/22/2006
Last updated
06/04/2008
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