Healthcare Provider Details

I. General information

NPI: 1356452825
Provider Name (Legal Business Name): JEAN-CHARLES M TOUSSAINT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 HIGHLAND AVE
WINCHESTER MA
01890
US

IV. Provider business mailing address

2 RYDER ROAD PO BOX 641
TRURO MA
02666
US

V. Phone/Fax

Practice location:
  • Phone: 781-756-7243
  • Fax: 781-756-2987
Mailing address:
  • Phone: 481-756-7243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number46474
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: