Provider Demographics
NPI:1104811900
Name:BLAUSTEIN, DAVID MARC (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MARC
Last Name:BLAUSTEIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1400 VFW PARKWAY
Mailing Address - Street 2:VA BOSTON HEALTHCARE SYSTEM
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132
Mailing Address - Country:US
Mailing Address - Phone:857-203-6931
Mailing Address - Fax:857-203-5680
Practice Address - Street 1:1400 VFW PARKWAY
Practice Address - Street 2:VA BOSTON HEALTHCARE SYSTEM
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132
Practice Address - Country:US
Practice Address - Phone:857-203-6931
Practice Address - Fax:857-203-5680
Is Sole Proprietor?:No
Enumeration Date:2005-09-18
Last Update Date:2019-04-26
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Provider Licenses
StateLicense IDTaxonomies
MA78218204C00000X, 208100000X, 2081N0008X, 2081P2900X, 2081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine