Individual
WILLIAM MOORE VANNEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
955 MAIN ST, WINCHESTER, MA 01890-1961
(781) 729-5855
(781) 721-5891
Mailing address
91 MONTVALE AVE, STONEHAM, MA 02180-3623
(781) 864-1295
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
38046
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0160725
—
MA
01
—
24794
US HEALTHCARE
MA
01
—
30034
HARVARD PILGRIM
MA
01
—
38046
TUFTS
MA
01
—
C20230
BLUE CROSS & BLUE SHIELD
MA
Enumeration date
05/28/2006
Last updated
11/06/2012
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