Individual
DOUGLAS C WAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
123 SUMMER ST, WORCESTER, MA 01608-1216
(508) 363-5000
(508) 363-7551
Mailing address
123 SUMMER STREET, WORCESTER, MA 06108-1216
(508) 363-5000
(508) 363-7551
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036071
CT
207R00000X
Internal Medicine Physician
73862
MA
207RI0200X
Infectious Disease Physician
Primary
036071
CT
207RI0200X
Infectious Disease Physician
73862
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001360718
—
CT
05
—
3117405
—
MA
Enumeration date
07/07/2005
Last updated
09/18/2014
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