Provider Demographics
NPI:1164502472
Name:KAROLOW, WAYNE WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:WILLIAM
Last Name:KAROLOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:148 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923
Mailing Address - Country:US
Mailing Address - Phone:978-777-2790
Mailing Address - Fax:978-946-8037
Practice Address - Street 1:1 GENERAL WAY
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01842
Practice Address - Country:US
Practice Address - Phone:978-683-4000
Practice Address - Fax:978-946-8037
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA36769207U00000X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Not Answered207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2066009Medicaid
MAB31110Medicare ID - Type Unspecified
MA2066009Medicaid