Most Relevant Information
Provider Data
| NPI Number: | 1003433087 |
| Provider Name: | ARIEL THETYS WAMPLER MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: | 264790 |
Most Important Dates
| Enumeration Date: | 06/25/2020 |
| Last Updated: | 06/25/2020 |
Provider Practice Location
41 BURLINGTON MALL ROAD
BURLINGTON
MA
018050001
Practice Location Phone/Fax
| Phone: | 7817448583 |
| Fax: |
Provider Mailing Location
41 BURLINGTON MALL ROAD
BURLINGTON
MA
018050001
Provider Mailing Phone/Fax
| Phone: | 7817448583 |
| Fax: |