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General NPI Number Information
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NPI Number | 1255514923
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Entity Type | Organization
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Legal Business Name | DEBORAH S. WOOTEN, M.D., LLC
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Dates
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Enumeration Date | 12/17/2007
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Last Update Date | 12/17/2007
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Provider Practice Location Address
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Address Line | 201 RIVER ST
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City | NORWELL
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State | MA
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Zip | 02061-2211
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Country | US
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Telephone | 781-659-4084
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Fax | 781-659-4065
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Provider Business Mailing Address
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Address Line | 201 RIVER ST
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City | NORWELL
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State | MA
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Zip | 02061-2211
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Country | US
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Telephone | 781-659-4084
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Fax | 781-659-4065
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Authorized Official
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Title or Position | OWNER
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Name | DR. DEBORAH SANDRA WOOTEN
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Credential | M.D.
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Telephone | 781-659-4084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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