| Dr Edward Michael Dussom, MD | |
| 736 Cambridge St, Brighton, MA 02135-2907 | |
| (617) 789-3000 | |
| Not Available | 
| Full Name | Dr Edward Michael Dussom | 
|---|---|
| Gender | Male | 
| Speciality | Surgery | 
| Location | 736 Cambridge St, Brighton, Massachusetts | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1053805457 | NPI | - | NPPES | 
| 110150184A | Medicaid | MA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208600000X | Surgery | 276408 (Massachusetts) | Secondary | 
| 208600000X | Surgery | 1016197 (Massachusetts) | Primary | 
| Entity Name | Bmc Affiliated Physicians, Inc. | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1245320910 PECOS PAC ID: 9830133123 Enrollment ID: O20050617000054 | 
| Entity Name | Steward Medical Group Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1629398219 PECOS PAC ID: 2860688728 Enrollment ID: O20101119000007 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Edward Michael Dussom, MD 960 Massachusetts Avenue, Fl 2, Boston, MA 02118-2690 Ph: () - | Dr Edward Michael Dussom, MD 736 Cambridge St, Brighton, MA 02135-2907 Ph: (617) 789-3000 | 
| Zahra Alhajji,  Surgery Medicare: Medicare Enrolled Practice Location: 736 Cambirdge St, Brighton, MA 02135 Phone: 617-789-2990 Fax: 617-789-3419 | |
| Oseogie Okojie, MD Surgery Medicare: Medicare Enrolled Practice Location: 736 Cambridge St, Brighton, MA 02135 Phone: 617-789-2777 | |
| Dr. Maria Arshanskiy, MD Surgery Medicare: Medicare Enrolled Practice Location: 736 Cambridge St, Brighton, MA 02135 Phone: 617-789-2990 | |
| Marvin J Lopez, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 11 Nevins St, Ste 201, Brighton, MA 02135 Phone: 617-789-2442 Fax: 617-789-4207 | |
| Dr. Aaron Richard Dezube, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 11 Nevins St, Suite 201, Brighton, MA 02135 Phone: 617-789-2442 Fax: 617-202-4349 | |
| Grace Lassiter, MD Surgery Medicare: Medicare Enrolled Practice Location: 736 Cambridge St, Brighton, MA 02135 Phone: 617-789-2000 |