Provider Demographics
NPI:1205825734
Name:WOLFE, GAIL RAE ZIMMERMANN (MD)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:RAE ZIMMERMANN
Last Name:WOLFE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22 W BOULEVARD RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTRE
Mailing Address - State:MA
Mailing Address - Zip Code:02459-1219
Mailing Address - Country:US
Mailing Address - Phone:617-527-7848
Mailing Address - Fax:617-562-7853
Practice Address - Street 1:736 CAMBRIDGE ST
Practice Address - Street 2:CARITA ST ELIZABETHS DEPT OF PATHOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2907
Practice Address - Country:US
Practice Address - Phone:617-789-2405
Practice Address - Fax:617-562-7853
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2007-07-08
Deactivation Date:2005-10-19
Deactivation Code:
Reactivation Date:2006-09-12
Provider Licenses
StateLicense IDTaxonomies
MA45727207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology