Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 57797 | MA |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 57797 | MA |
NPI | 1205819505 |
---|---|
Provider Name | Dr. May Wakamatsu |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-2621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2005 |
Last Update Date | 24/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
057797 | TUFTS HEALTH PLAN (01) | MA |
3068374 | (05) | MA |
B76717 | (02) | |
J06603 | BCBS MA (01) | MA |