Provider Demographics
NPI:1871052076
Name:WOBMA, HOLLY MICHELLE (MD, PHD)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:MICHELLE
Last Name:WOBMA
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOSTON CHILDREN'S HOSPITAL
Mailing Address - Street 2:300 LONGWOOD AVE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-355-8241
Mailing Address - Fax:
Practice Address - Street 1:BOSTON CHILDREN'S HOSPITAL
Practice Address - Street 2:300 LONGWOOD AVE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:347-928-9925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2019-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program