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Individual

DR. WALTER WICKREMASINGHE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
274823
MA
208000000X
Pediatrics Physician
A131895
CA
208000000X
Pediatrics Physician
R3246
TX

Other

Enumeration date
04/11/2013
Last updated
02/06/2020
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