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NPI Code Detail

MEDICARE: MR. VINCENT M WAITE MD

MEDICARE: MR. VINCENT M WAITE MD
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
1207Q00000XFamily Medicine Physician234258MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932194032
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. VINCENT M WAITE MD
Provider Business Mailing Address
First Line : 34 HAVERHILL ST
Second Line :
City : LAWRENCE
State : MA
Zip : 01841-2884
Country : US
Telephone Number : 978-686-0090
Fax Number : 978-681-5963
Provider Business Practice Location Address
First Line : 34 HAVERHILL ST
Second Line :
City : LAWRENCE
State : MA
Zip : 01841-2884
Country : US
Telephone Number : 978-686-0090
Fax Number : 978-681-5963
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2005
Last Update Date : 04/21/2016

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Directions to “ MR. VINCENT M WAITE MD” Practice Location

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