Provider Demographics
NPI:1205022639
Name:WIGMORE, ROBIN E (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:E
Last Name:WIGMORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:13 WORCESTER SQ
Mailing Address - Street 2:APARTMENT 1
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2935
Mailing Address - Country:US
Mailing Address - Phone:617-632-7706
Mailing Address - Fax:
Practice Address - Street 1:330 BROOKLINE AVE E/SHAPIRO 6TH FLOOR
Practice Address - Street 2:BETH ISRAEL DEACONESS MEDICAL CENTER HCA
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215
Practice Address - Country:US
Practice Address - Phone:617-754-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA233380207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease