Individual
KYLE WICKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 ALBANY ST, BOSTON, MA 02119-2560
(617) 638-8000
Mailing address
801 ALBANY ST, BOSTON, MA 02119-2560
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A207633
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2023
Last updated
04/21/2026
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