Individual
KAREN WISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
281 LINCOLN ST, DEPARTMENT OF DERMATOLOGY, WORCESTER, MA 01605-2138
(508) 334-5979
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
71261
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110047205A
—
MA
05
—
3050408
—
MA
Enumeration date
12/01/2005
Last updated
11/17/2020
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