Provider Demographics
NPI:1598840951
Name:WAUGH, MATTHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:WAUGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:24 LYMAN ST
Mailing Address - Street 2:SUITE 280
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-1482
Mailing Address - Country:US
Mailing Address - Phone:508-366-2320
Mailing Address - Fax:508-366-0083
Practice Address - Street 1:24 LYMAN ST
Practice Address - Street 2:SUITE 280
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1482
Practice Address - Country:US
Practice Address - Phone:508-366-2320
Practice Address - Fax:508-366-0083
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA230304208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics