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Individual

W ANTHONY WAKIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
31 ROCHE BROTHERS WAY, TWP, SUITE 140, N EASTON, MA 02767
(508) 894-0400
(508) 894-0332
Mailing address
1215 BROADWAY, RAYNHAM, MA 02767
(508) 894-0400
(508) 559-7035

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1715
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0361291
MA
Enumeration date
11/23/2005
Last updated
09/25/2017
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