Provider Demographics
NPI:1790912285
Name:WAKEMAN, SARAH E (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:E
Last Name:WAKEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:MASSACHUSETTS GENERAL HOSPITAL
Mailing Address - Street 2:55 FRUIT STREET, CTN
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114
Mailing Address - Country:US
Mailing Address - Phone:617-724-8135
Mailing Address - Fax:617-724-8010
Practice Address - Street 1:73 HIGH ST
Practice Address - Street 2:CHARLESTOWN HEALTHCARE CENTER
Practice Address - City:CHARLESTOWN
Practice Address - State:MA
Practice Address - Zip Code:02129-3026
Practice Address - Country:US
Practice Address - Phone:617-724-8135
Practice Address - Fax:617-724-8010
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MAL-240170207R00000X
MA248998207RA0401X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine