Healthcare Provider Details

I. General information

NPI: 1295703783
Provider Name (Legal Business Name): WILLIAM M SARGENT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 LONG POND DR FONTAINE MEDICAL CENTER
HARWICH MA
02645
US

IV. Provider business mailing address

525 LONG POND DR FONTAINE MEDICAL CENTER
HARWICH MA
02645
US

V. Phone/Fax

Practice location:
  • Phone: 508-432-4100
  • Fax: 508-432-8951
Mailing address:
  • Phone: 508-432-4100
  • Fax: 508-432-8951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number159337
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: