SAN WAN, MDPC (NPI# 1699748541) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699748541 |
| Entity Type | Organization |
| Organization Name | SAN WAN, MDPC |
| Practice Address |
340 Wood Rd Braintree MA 02184-2401 |
| Mailing Address |
8 Wildflower Ln Weston MA 02493-1167 |
| Practice Telephone | 7818491111 |
| Mailing Telephone | 7816479863 |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | SAN WAN (PRESIDENT) |
| Authorized Official Telephone | 7816479863 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | BLUE CROSS BLUE SHIELD | M13923 | 01 |
| MA | 9737812 | 05 |
| Street Address |
340 WOOD RD |
| City | BRAINTREE |
| State | MA |
| Zip Code | 02184-2401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538140868 | Kathryn Anne Foley Ferrari | Physical Therapist | 340 Wood Rd, Suite 303, Braintree, MA 02184-2401 | 2005-11-14 |
| 1578054730 | Angela Tchao | Optometrist | 340 Wood Rd, Braintree, MA 02184 | 2018-05-23 |
| 1598219313 | Sydney Galvin | Physical Therapist | 340 Wood Rd, Ste 303, Braintree, MA 02184-2401 | 2016-08-10 |
| 1184002180 | Jack and Jill Pediatric Dentistry, LLC | Dentist | 340 Wood Rd, Suite 288, Braintree, MA 02184-2401 | 2015-05-11 |
| 1396150629 | Blue Hills Sport & Spine Rehabilitation, LLC | Physical Therapist | 340 Wood Rd, Ste 303, Braintree, MA 02184-2401 | 2014-06-25 |
| 1881024545 | Crowning Moment LLC | Preferred Provider Organization | 340 Wood Rd, Suite 288, Braintree, MA 02184-2401 | 2013-11-16 |
| 1750654018 | Brad Thorne | Counselor | 340 Wood Rd, Braintree, MA 02184-2401 | 2012-02-17 |
| 1992935381 | Allison P Daly | Nurse Practitioner | 340 Wood Rd, 305, Braintree, MA 02184-2401 | 2009-07-20 |
| 1780819300 | New England Pain Associates, PC | Anesthesiology | 340 Wood Rd, Ste. 204, Braintree, MA 02184-2401 | 2009-05-27 |
| 1710145867 | Deborah Levenson | Physical Therapist | 340 Wood Rd, Suite 102, Braintree, MA 02184-2401 | 2008-05-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342234 | Albert Jusu | Counselor | Arbour Counseling Services, 400 Washington Street, Braintree, MA 02184 | 2020-10-05 |
| 1356952378 | Samantha Taylor O'malley | Student in an Organized Health Care Education/Training Program | 639 Granite Street, N/a, Brainetree, MA 02184 | 2020-08-13 |
| 1184104499 | Andrea Boudreau | Social Worker | Coastal Dcf, 220 R Forbes Road, Braintree, MA 02184 | 2018-08-16 |
| 1144747221 | Mina Schafft Dmd Pllc | Dentist | 321 Washington Street, Unit 101, Westwood, MA 02184 | 2017-08-29 |
| 1922520592 | Samson Michel | Counselor | 400 Washington St. Suite 106, Braintree, MA 02184 | 2017-07-14 |
| 1760912653 | Shannon R Harvey | Behavioral Analyst | 501 Commerce Dr 4207, Braintree, MA 02184 | 2017-06-14 |
| 1275074429 | Colleen Dalton | Behavioral Analyst | 32 Powder Hill Dr, Braintree, MA 02184 | 2017-03-20 |
| 1295273266 | Jessica Morris | Occupational Therapist | 16 Kensington Street, Braintree, MA 02184 | 2017-02-09 |
| 1568834562 | Lisa Morrill | Counselor | 400 Washington St Ste 106, Braintree, MA 02184 | 2015-10-29 |
| 1831560382 | Dr Dental of Braintree PC | Dentist | 284 Grove St, Braintree, MA 02184 | 2015-10-09 |
| Find all providers in zip 02184 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205916020 | Daniel Todd Finn | Dermatology | 400 Washington St, Suite 200, Braintree, MA 02184 | 2006-10-16 |
| 1578673190 | Stephen V. Tang | Dermatology | 111 Grossman Dr, Braintree, MA 02184-4997 | 2006-08-30 |
| 1295707123 | San Wan | Dermatology | 340 Wood Rd, Braintree, MA 02184-2401 | 2006-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669090445 | Peter T Demos Md | Dermatology | 125 Liberty St Ste 206, Springfield, MA 01103-1109 | 2020-07-08 |
| 1376180760 | Integrated Dermatology of Needham, LLC | Dermatology | 60 Dedham Ave Ste 206, Needham, MA 02492-3061 | 2019-12-04 |
| 1164069647 | Integrated Dermatology of Mashton, LLC | Dermatology | 800 Falmouth Rd Ste 101, Mashpee, MA 02649-3303 | 2019-12-04 |
| 1972164937 | Kuchnir Realty, LLC | Dermatology | 11 Apex Dr Ste 103a, Marlborough, MA 01752-1860 | 2019-06-21 |
| 1265098032 | Mark Amster Derm | Dermatology | 800 Falmouth Rd Ste 101b, Mashpee, MA 02649-3352 | 2019-05-16 |
| 1831684224 | Chotinij Lertphanichkul | Dermatology | 850 Boylston St Ste 437, Chestnut Hill, MA 02467-2405 | 2018-06-27 |
| 1023515277 | Vibrant Dermatology Pllc | Dermatology | 588 Providence Hwy, Dedham, MA 02026-6804 | 2018-04-12 |
| 1437665908 | Kuchnir Dermatology, PC | Dermatology | 20 Hope Ave Ste 105, Waltham, MA 02453-2717 | 2017-12-20 |
| 1265941082 | Integrated Dermatology Group, LLC | Dermatology | 280 Washington St Ste 212, Brighton, MA 02135-3511 | 2017-09-25 |
| 1679098750 | Avant-garde Medical LLC | Dermatology | 62 Pleasant St, Natick, MA 01760-5634 | 2017-08-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.