Provider Demographics
NPI:1790854859
Name:WAINGER, BRIAN J (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:J
Last Name:WAINGER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:15 PARKMAN ST
Mailing Address - Street 2:MGH CENTER FOR PAIN MEDICINE WANG SUITE 340
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-3117
Mailing Address - Country:US
Mailing Address - Phone:617-726-8810
Mailing Address - Fax:617-726-3441
Practice Address - Street 1:15 PARKMAN ST
Practice Address - Street 2:MGH CENTER FOR PAIN MEDICINE WANG SUITE 340
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-726-8810
Practice Address - Fax:617-726-3441
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2017-06-15
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Provider Licenses
StateLicense IDTaxonomies
MA230440207L00000X, 207LP2900X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine