Waltzman, Mark L

Waltzman, Mark L is an individual health care provider with primary practice located at Children'S Hospital Boston Division Of Emergency 300 Longwood Ave, Boson MA 02115. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is his primary health care specialty. Waltzman, Mark L can be contacted via phone (617) 355-6624.

Contact Information

Primary practice address
Children'S Hospital Boston Division Of Emergency 300 Longwood Ave Boson MA 02115
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 153293 Massachusetts
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X 153293 Massachusetts

Profile Details

NPI number 1740248970
LBN Legal business name Waltzman, Mark L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated Oct 27th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740248970 NPPES
Massachusetts MEDICAID 3193240

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