Organization
NORTHSHORE PLASTIC SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID J WAGES M.D. (PRESIDENT)
(978) 531-6966
Entity
Organization
Contact information
Practice address
4 CENTENNIAL DR, STE 102, PEABODY, MA 01960-7935
(978) 531-6966
(978) 531-2221
Mailing address
340 MAIN ST, STE. 670, WORCESTER, MA 01608-1604
(508) 754-3566
(508) 798-8012
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9707573
—
MA
Enumeration date
07/13/2005
Last updated
07/21/2022
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