Healthcare Provider Details

I. General information

NPI: 1710990312
Provider Name (Legal Business Name): MARTIN FUSS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 CASS AVE STE 1
WOONSOCKET RI
02895-4705
US

IV. Provider business mailing address

115 CASS AVE STE 1
WOONSOCKET RI
02895-4705
US

V. Phone/Fax

Practice location:
  • Phone: 401-356-1701
  • Fax: 401-356-4537
Mailing address:
  • Phone: 401-356-1701
  • Fax: 401-356-4537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD169914
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD20810
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: