Individual
DR. FREDERICK DAVID WAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
345 COURT ST, SUITE 201, PLYMOUTH, MA 02360-4329
(508) 747-0050
(508) 747-2001
Mailing address
345 COURT ST, SUITE 201, PLYMOUTH, MA 02360-4329
(508) 747-0050
(508) 747-2001
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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