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Individual

DR. LISA TRACY WOLLMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
690 CANTON ST STE 240, WESTWOOD, MA 02090-2326
(339) 204-9516
(781) 459-4698
Mailing address
690 CANTON ST STE 240, WESTWOOD, MA 02090-2326
(339) 204-9516
(781) 459-4698

Taxonomy

Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
77484
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3108759
MA
01
739827
TUFTS HEALTH PLAN
MA
01
J13877
BCBS MA
MA
Enumeration date
11/07/2005
Last updated
11/21/2019
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