Provider Demographics
NPI:1013282821
Name:STASON, WILLIAM BOAZ (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BOAZ
Last Name:STASON
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 1:29 SANDY POND RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:MA
Mailing Address - Zip Code:01773-2006
Mailing Address - Country:US
Mailing Address - Phone:781-259-8939
Mailing Address - Fax:
Practice Address - Street 1:29 SANDY POND RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:MA
Practice Address - Zip Code:01773-2006
Practice Address - Country:US
Practice Address - Phone:781-259-8939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-12
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA32680207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease