Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 265203 | MA |
NPI | 1003950569 |
---|---|
Provider Name | Dr. Robert P Waugh |
First Address | Stoneham, MA 02180-3629 |
Second Address | Stoneham, MA 02180-3647 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2007 |
Last Update Date | 31/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001733301 | MEDICARE PTAN (01) | |
30209642 | (05) | NH |