Provider Demographics
NPI:1124141940
Name:HAUSER, RUSS (MD)
Entity type:Individual
Prefix:DR
First Name:RUSS
Middle Name:
Last Name:HAUSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 EXETER ST
Mailing Address - Street 2:APT 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-2207
Mailing Address - Country:US
Mailing Address - Phone:617-432-3326
Mailing Address - Fax:
Practice Address - Street 1:665 HUNTINGTON AVE
Practice Address - Street 2:BUILDING I ROOM 1405
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6021
Practice Address - Country:US
Practice Address - Phone:617-432-3326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA570242083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine