Individual
DR. DEBORAH JEAN WALD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 OCEAN AVE, RHC REVERE HEALTHCARE CENTER, REVERE, MA 02151-3675
(617) 485-6350
(617) 485-6391
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
79608
MA
208000000X
Pediatrics Physician
Primary
79608
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3138968
—
MA
01
—
724447
TUFTS HEALTH PLAN
MA
01
—
J31234
BCBS MA
MA
Enumeration date
10/31/2005
Last updated
09/11/2025
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