Individual
DR. FREDERICK DAVID WAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
43674
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070009900
RAILROAD MEDICARE
—
01
—
J20061
BLUECROSS/BLUESHIELD OF MASSACHUSETTS
MA
Enumeration date
08/12/2006
Last updated
05/07/2008
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