Individual
DR. WANDA PHIPATANAKUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MS
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6117
(617) 730-0310
Mailing address
30 OVERLOOK RD, HOPKINTON, MA 01748-3220
(508) 497-2345
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
204416
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3207980
—
MA
Enumeration date
09/20/2006
Last updated
07/08/2007
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