Provider Demographics
NPI:1366459109
Name:HARWICK, FREDERICK W (DO)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:W
Last Name:HARWICK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 HOSPITAL RD
Mailing Address - Street 2:WING EMERGENCY SERVICES PC
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453
Mailing Address - Country:US
Mailing Address - Phone:978-466-2994
Mailing Address - Fax:978-466-2993
Practice Address - Street 1:40 WRIGHT ST
Practice Address - Street 2:WING MEMORIAL HOSPITAL
Practice Address - City:PALMER
Practice Address - State:MA
Practice Address - Zip Code:01069
Practice Address - Country:US
Practice Address - Phone:413-284-5308
Practice Address - Fax:413-284-5704
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA72232207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3058786Medicaid
MA3058786Medicaid
Y02538Medicare ID - Type Unspecified