MEDICARE: WAYNE A D E CHIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	70732	MA

General Provider Information

NPI Number	:	1205894102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WAYNE A D E CHIN M.D.

Provider Business Mailing Address
First Line	:	55 FOGG RD
Second Line	:
City	:	SOUTH WEYMOUTH
State	:	MA
Zip	:	02190-2432
Country	:	US
Telephone Number	:	781-340-4294
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 FOGG RD.
Second Line	:	SO. SHORE HOSP.
City	:	WEYMOUTH
State	:	MA
Zip	:	02190
Country	:	US
Telephone Number	:	781-340-4294
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	09/22/2022

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