Individual
DR. SHAUN E. WASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
725 ALBANY ST, SHAPIRO 3B, BOSTON, MA 02118
(617) 638-8485
(617) 414-7372
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
267102
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10080755
OPTIMA HEALTH
VA
05
—
110117646A
—
MA
01
—
1134242803
TRICARE/CHAMPUS
VA
05
—
1134242803
—
VA
01
—
438597
ANTHEM BC/BS
VA
05
—
5917952
—
NC
01
—
PAR
MULTIPLAN
VA
Enumeration date
04/09/2007
Last updated
01/05/2017
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