Individual
MATTHEW R FICKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
355 WAVERLEY OAKS RD, SUITE 200, WALTHAM, MA 02452-8474
(781) 647-6920
(781) 891-0056
Mailing address
355 WAVERLEY OAKS RD, SUITE 200, WALTHAM, MA 02452-8474
(781) 647-6920
(781) 891-0056
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
231500
MA
207SG0201X
Clinical Genetics (M.D.) Physician
231500
MA
208000000X
Pediatrics Physician
231500
MA
Other
Enumeration date
09/02/2006
Last updated
04/18/2013
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