Individual
DR. WALTER PANIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
125 NASHUA ST, SRH SPAULDING REHAB HOSPITAL, BOSTON, MA 02114-1101
(617) 573-2628
(617) 573-7119
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
40760
MA
2084N0400X
Neurology Physician
40760
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2067684
—
MA
01
—
701135
TUFTS HEALTH PLAN
MA
01
—
M09898
BCBS MA
MA
Enumeration date
10/26/2005
Last updated
09/11/2025
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