Individual
KENNETH WAKWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 BOSTON MEDICAL CTR PL, BOSTON, MA 02118-2908
(617) 414-5481
Mailing address
1 BOSTON MEDICAL CTR PL, BOSTON, MA 02118-2908
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/16/2019
Last updated
10/30/2019
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