Provider Demographics
NPI:1962762203
Name:WAGES, DAVID SIMS (MD PLD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:SIMS
Last Name:WAGES
Suffix:
Gender:M
Credentials:MD PLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 PINECONE LANE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BOROULH
Mailing Address - State:MA
Mailing Address - Zip Code:01772-1244
Mailing Address - Country:US
Mailing Address - Phone:508-481-0077
Mailing Address - Fax:
Practice Address - Street 1:31 PINECONE LANE
Practice Address - Street 2:
Practice Address - City:SOUTH BOROULH
Practice Address - State:MA
Practice Address - Zip Code:01772-1244
Practice Address - Country:US
Practice Address - Phone:508-481-0077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG78812207ZH0000X, 208U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
No208U00000XAllopathic & Osteopathic PhysiciansClinical Pharmacology