Individual
BARBARA SHAKER WAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
63 MAIN ST, BROCKTON, MA 02301-4042
(508) 559-6699
(508) 583-4649
Mailing address
63 MAIN ST, BROCKTON, MA 02301-4042
(508) 559-6699
(508) 559-5073
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
124599
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0036811
NEIGHBORHOOD HEALTH PLAN
—
01
—
CN0308
BLUE CROSS BLUE SHIELD
—
Enumeration date
06/27/2006
Last updated
03/29/2016
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