Individual
DR. EMILY S WAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1400 VFW PKWY, WEST ROXBURY, MA 02132-4927
(617) 323-7700
Mailing address
1400 VFW PKWY, WEST ROXBURY, MA 02132-4927
(617) 323-7700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
223189
MA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
223189
MA
207RP1001X
Pulmonary Disease Physician
Primary
223189
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2102251
—
MA
01
—
468196
TUFTS HEALTH PLAN
MA
01
—
J28640
BCBS MA
MA
Enumeration date
11/03/2005
Last updated
05/19/2023
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