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Individual

DR. MICHAEL J WHALEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
55 FRUIT STREET ELL 3, PEDIATRIC CARE UNIT, BOSTON, MA 02114-2696
(617) 724-4380
(617) 724-2696
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
157539
MA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
157539
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
157539
TUFTS HEALTH PLAN
MA
05
3182550
MA
01
J19249
BCBS MA
MA
Enumeration date
10/18/2006
Last updated
05/20/2020
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