Individual
LINA C. VAWTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-2527
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
238141
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110086459A
—
MA
Enumeration date
02/08/2007
Last updated
12/09/2011
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