Provider Demographics
NPI:1699758896
Name:MUSTO, PAUL C (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:C
Last Name:MUSTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:10 WILLARD ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-1281
Mailing Address - Country:US
Mailing Address - Phone:617-769-1162
Mailing Address - Fax:617-770-9491
Practice Address - Street 1:51 PERFORMANCE DR
Practice Address - Street 2:SUITE 110
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-3141
Practice Address - Country:US
Practice Address - Phone:617-769-1162
Practice Address - Fax:617-770-9491
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA50948207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3008096Medicaid
MAB20041401OtherCIGNA
MA0027771OtherAETNA US HEALTH
MA705747OtherTUFTS HEALTH CARE
MA9241OtherHARVARD PILGRIM
MAJ02033OtherBLUE CROSS BLUE SHIELD
MAA56308Medicare UPIN
MAB20041401OtherCIGNA