Provider Demographics
NPI:1114048360
Name:LAMORTE, WAYNE W (MD)
Entity Type:Individual
Prefix:
First Name:WAYNE
Middle Name:W
Last Name:LAMORTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 WHIPPLE CIR
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1718
Mailing Address - Country:US
Mailing Address - Phone:617-638-5073
Mailing Address - Fax:
Practice Address - Street 1:BOSTON UNIV SHC OF MED
Practice Address - Street 2:80 EAST CONCORD STREET
Practice Address - City:ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-638-5073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA420062083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine