Provider Demographics
NPI:1417147513
Name:WHEELOCK, LUCINDA H (MD)
Entity Type:Individual
Prefix:
First Name:LUCINDA
Middle Name:H
Last Name:WHEELOCK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BUFFY RD
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02019-2854
Mailing Address - Country:US
Mailing Address - Phone:508-334-3734
Mailing Address - Fax:
Practice Address - Street 1:UMASS MEDICAL CENTER
Practice Address - Street 2:55 LAKE AVE. NORTH
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01655
Practice Address - Country:US
Practice Address - Phone:508-334-3734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA233768207ZB0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine