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General NPI Number Information
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NPI Number | 1558541409
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Entity Type | Organization
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Legal Business Name | J. WALLACE MCMEEL, M.D., P.C.
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Dates
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Enumeration Date | 11/08/2007
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Last Update Date | 11/08/2007
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Provider Practice Location Address
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Address Line | 1 AUTUMN ST 6TH FLOOR
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City | BOSTON
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State | MA
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Zip | 02215-5301
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Country | US
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Telephone | 617-632-7777
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Fax | 617-632-7770
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Provider Business Mailing Address
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Address Line | 1 AUTUMN ST 6TH FLOOR
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City | BOSTON
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State | MA
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Zip | 02215-5301
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Country | US
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Telephone | 617-632-7777
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Fax | 617-632-7770
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Authorized Official
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Title or Position | DIR OF CLINICAL&BUSINESS OPERATIONS
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Name | MS. MARJIE S WHITTEMORE
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Credential |
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Telephone | 617-632-7776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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