Provider Demographics
NPI:1548607799
Name:KANJ, WAJDI W (MD)
Entity Type:Individual
Prefix:
First Name:WAJDI
Middle Name:W
Last Name:KANJ
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 1:2000 WASHINGTON ST
Mailing Address - Street 2:STE 341
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1625
Mailing Address - Country:US
Mailing Address - Phone:617-964-0024
Mailing Address - Fax:617-964-3619
Practice Address - Street 1:2000 WASHINGTON ST
Practice Address - Street 2:STE 341
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1625
Practice Address - Country:US
Practice Address - Phone:617-964-0024
Practice Address - Fax:617-964-3619
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MAL-255540207XS0106X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery