Provider Demographics
NPI:1073571436
Name:WACHS, DAVID M (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:WACHS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2014 WASHINGTON ST
Mailing Address - Street 2:NWH HOSPITALIST DEPARTMENT
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1607
Mailing Address - Country:US
Mailing Address - Phone:617-243-6433
Mailing Address - Fax:617-243-5148
Practice Address - Street 1:2014 WASHINGTON ST
Practice Address - Street 2:NEWTON WELLESLEY HOSPITAL - HOSPITALIST DEPARTMENT
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1607
Practice Address - Country:US
Practice Address - Phone:617-243-6433
Practice Address - Fax:617-243-5148
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2009-10-16
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Provider Licenses
StateLicense IDTaxonomies
MA227427207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110079249Medicaid
MA110079249Medicaid
MAA40064Medicare PIN