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Individual

WALT A KAGAN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
10 WILLARD ST, QUINCY, MA 02169-1281
(617) 479-1437
(617) 479-3500
Mailing address
10 WILLARD ST, QUINCY, MA 02169-1281
(617) 479-1437
(617) 479-3500

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
45805
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0151505
MA
01
21722
AETNA US HEALTH
MA
01
45805
TUFTS HEALTH CARE
MA
01
66033
HARVARD PILGRIM
MA
01
B20028501
CIGNA
MA
01
B49039
BLUE CROSS BLUE SHIELD
MA
Enumeration date
11/15/2005
Last updated
07/08/2007
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