Organization
NSEA WHAIPA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. C. DOUGLAS EVANS MD (OWNER)
(781) 245-5200
Entity
Organization
Contact information
Practice address
669 MAIN STREET, WAKEFIELD, MA 01880-5221
(781) 245-5200
(781) 246-3932
Mailing address
669 MAIN STREET, WAKEFIELD, MA 01880-5221
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
08/01/2019
Last updated
08/01/2019
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