Theodore C Weatherwax, MD | |
55 Fruit St, Boston, MA 02114-2621 | |
(617) 726-3557 | |
Not Available |
Full Name | Theodore C Weatherwax |
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Gender | Male |
Speciality | Family Medicine - Addiction Medicine |
Location | 55 Fruit St, Boston, Massachusetts |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1144882879 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | MDRE.ML.60958797 (Washington) | Secondary |
207QA0401X | Family Medicine - Addiction Medicine | 291350 (Massachusetts) | Primary |
Entity Name | Massachusetts General Physicians Organization Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801874573 PECOS PAC ID: 2466365820 Enrollment ID: O20031111000434 |
Entity Name | The General Hospital Corporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1023049236 PECOS PAC ID: 6507803806 Enrollment ID: O20080313000351 |
Mailing Address | Practice Location Address |
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Theodore C Weatherwax, MD 2209 E 32nd St, Tacoma, WA 98404-4922 Ph: (253) 593-0232 | Theodore C Weatherwax, MD 55 Fruit St, Boston, MA 02114-2621 Ph: (617) 726-3557 |
Lidya H Wlasiuk, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 850 Harrison Ave, Yacc 5, Boston, MA 02118 Phone: 617-414-2080 Fax: 617-414-2090 | |
Nestor Alejandro Sainz Rueda, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 55 Fruit St, Boston, MA 02114 Phone: 800-711-4644 | |
Madhuri Preeti Rao, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 55 Fruit St, Boston, MA 02114 Phone: 617-889-8580 | |
Brian R Penti, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 850 Harrison Ave, Yacc 4, Boston, MA 02118 Phone: 617-414-2080 Fax: 617-414-2090 | |
Shahnaz Rahman, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 820 Harrison Ave, Boston, MA 02118 Phone: 404-259-4008 | |
Dr. Rohit Abraham, MD, MPH, MAT Family Medicine Medicare: Medicare Enrolled Practice Location: 75 Francis St, Boston, MA 02115 Phone: 617-732-5500 | |
Dr. Amy Min He, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 637 Washington St, Boston, MA 02124 Phone: 617-825-9660 |