Healthcare Provider Details

I. General information

NPI: 1366459109
Provider Name (Legal Business Name): FREDERICK W HARWICK DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 WRIGHT ST WING MEMORIAL HOSPITAL
PALMER MA
01069
US

IV. Provider business mailing address

60 HOSPITAL RD WING EMERGENCY SERVICES PC
LEOMINSTER MA
01453
US

V. Phone/Fax

Practice location:
  • Phone: 413-284-5308
  • Fax: 413-284-5704
Mailing address:
  • Phone: 978-466-2994
  • Fax: 978-466-2993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number72232
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: