Provider Demographics
NPI:1093794042
Name:SAWYER, RICHARD FREDERICK JR (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:FREDERICK
Last Name:SAWYER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 MERRIMACK ST
Mailing Address - Street 2:STE 201
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-5821
Mailing Address - Country:US
Mailing Address - Phone:978-691-5160
Mailing Address - Fax:978-691-5163
Practice Address - Street 1:411 MERRIMACK ST
Practice Address - Street 2:STE 201
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-5821
Practice Address - Country:US
Practice Address - Phone:978-691-5160
Practice Address - Fax:978-691-5163
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA79008207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3133427Medicaid
MAJ14490Medicare ID - Type Unspecified
MA3133427Medicaid