Individual
DR. CHRISTOPHER J. WLAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
57 GEORGE ST, PLAINVILLE, MA 02762-1601
(508) 944-2866
Mailing address
57 GEORGE ST, PLAINVILLE, MA 02762-1601
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
42944
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0109886
—
MA
05
—
238074
—
MA
01
—
4142-3
RI BCBS GROUP NUMBER
RI
05
—
9741836
—
MA
01
—
M14099
MA BCBS GROUP NUMBER
MA
01
—
S009570
CHAMPUS GROUP NUMBER
—
Enumeration date
11/08/2006
Last updated
01/31/2016
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