Individual
DAVID E WAZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
593 EDDY ST, DEPARTMENT OF RADIATION ONCOLOGY, PROVIDENCE, RI 02903-4923
(401) 444-8311
(401) 444-5335
Mailing address
593 EDDY ST, DEPARTMENT OF RADIATION ONCOLOGY, PROVIDENCE, RI 02903-4923
(401) 444-8311
(401) 444-5335
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
00-59408
MA
2085R0001X
Radiation Oncology Physician
Primary
MD09674
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0190162
CIGNA
RI
01
—
2400030
UNITED HEALTHCARE
RI
05
—
3032477
—
MA
01
—
4804-8
BLUE CROSS BLUE SHIELD
RI
05
—
7006674
—
RI
01
—
709180
TUFTS HEALTH PLAN
MA
01
—
P00762784
RAILROAD MEDICARE - RADIOSURGERY CENTER OF RI
RI
Enumeration date
04/17/2006
Last updated
04/19/2024
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