Individual
DR. MICHAEL WAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., B.SC.
Contact information
Practice address
300 LONGWOOD AVE, FEGAN 4TH FLOOR, BOSTON, MA 02115-5724
(617) 355-6668
Mailing address
1575 TREMONT ST, APARTMENT 304, BOSTON, MA 02120-1677
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
254990
MA
Other
Enumeration date
06/25/2013
Last updated
01/02/2014
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