Individual
DR. WALTER H DZIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, WRN 2 PATHOLOGY ASSOCIATES, BOSTON, MA 02114-2621
(617) 726-3715
(617) 726-6832
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-3715
(617) 726-6832
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
56321
MA
207RH0000X
Hematology (Internal Medicine) Physician
Primary
56321
MA
207ZB0001X
Blood Banking & Transfusion Medicine Physician
56321
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3002446
—
MA
01
—
791725
TUFTS HEALTH PLAN
MA
01
—
J05450
BCBS MA
MA
Enumeration date
11/04/2005
Last updated
10/21/2013
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