Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 248998 | MA |
Y | 111NI0900X | Internist | 248998 | MA |
N | 207R00000X | Internist | L-240170 | MA |
N | 111NI0900X | Internist | L-240170 | MA |
N | 207RA0401X | Internist - Addiction Medicine | 248998 | MA |
NPI | 1790912285 |
---|---|
Provider Name | Dr. Sarah E Wakeman |
First Address | Boston, MA 02114 |
Second Address | Charlestown, MA 02129-3026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2009 |
Last Update Date | 01/09/2021 |