Provider Demographics
NPI:1487632543
Name:DUBUISSON, DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:DUBUISSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:95 TREMONT ST
Mailing Address - Street 2:SUITE 15
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-4738
Mailing Address - Country:US
Mailing Address - Phone:781-934-7988
Mailing Address - Fax:781-934-7989
Practice Address - Street 1:95 TREMONT ST
Practice Address - Street 2:SUITE 15
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-4738
Practice Address - Country:US
Practice Address - Phone:781-934-7988
Practice Address - Fax:781-934-7989
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-08
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA50934207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110064938AMedicaid
MAJ02373OtherBLUE CROSS BLUE SHIELD
MA249509500OtherUS DEPT OF LABOR
MA702659OtherTUFTS
MAAA43674OtherHARVARD PILGRIM
MAJ02373Medicare ID - Type Unspecified