Weatherwax, Theodore C

Weatherwax, Theodore C is an individual health care provider with primary practice located at 55 Fruit St , Boston MA 02114-2621. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Weatherwax, Theodore C can be contacted via phone (617) 726-3557.

Contact Information

Primary practice address
55 Fruit St Boston MA 02114-2621
Phone: (617) 726-3557
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MDRE.ML.60958797 Washington
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X 291350 Massachusetts

Profile Details

NPI number 1144882879
LBN Legal business name Weatherwax, Theodore C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 2nd, 2019
Last updated Nov 23rd, 2022 - about 2 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.

Request for update

Popular Providers