Individual provider · NPI-1
David Marc Blaustein, MD
Neuromusculoskeletal Medicine, Sports Medicine · West Roxbury, MA
NPI number1104811900
StatusActive
Last updated in NPPESApr 26, 2019
Details
- NPI
- 1104811900
- Entity type
- Individual (NPI-1)
- Name
- David Marc Blaustein
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 18, 2005
- Last updated
- Apr 26, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 204C00000X | Neuromusculoskeletal Medicine, Sports Medicine | 78218 | MA | Yes |
| 208100000X | Physical Medicine & Rehabilitation | 78218 | MA | |
| 2081N0008X | Physical Medicine & Rehabilitation, Neuromuscular Medicine | 78218 | MA | |
| 2081P2900X | Physical Medicine & Rehabilitation, Pain Medicine | 78218 | MA | |
| 2081S0010X | Physical Medicine & Rehabilitation, Sports Medicine | 78218 | MA |
Practice location
1400 Vfw ParkwayVa Boston Healthcare System
West Roxbury, MA 02132
Phone 857-203-6931 · Fax 857-203-5680
Mailing address
1400 Vfw ParkwayVa Boston Healthcare System
West Roxbury, MA 02132
Phone 857-203-6931 · Fax 857-203-5680
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