Provider Demographics
NPI:1447233549
Name:NIEMIERKO, EWA (MD)
Entity Type:Individual
Prefix:
First Name:EWA
Middle Name:
Last Name:NIEMIERKO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:131 OLD ROAD TO 9 ACRE COR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-4181
Mailing Address - Country:US
Mailing Address - Phone:978-287-3436
Mailing Address - Fax:978-287-3642
Practice Address - Street 1:131 ORNAC
Practice Address - Street 2:JOHN CUMMING BLDG #200
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-4181
Practice Address - Country:US
Practice Address - Phone:978-287-3436
Practice Address - Fax:978-287-3642
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2012-11-20
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Provider Licenses
StateLicense IDTaxonomies
MA160258207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ22840OtherBLUE CROSS BLUE SHIELD
MA14512OtherHARVARD PILGRIM
MA2554249OtherAETNA US HEALTH
MAB20992701OtherCIGNA
MA0121746Medicaid
MA408304OtherTUFTS HEALTH CARE
MAB20992701OtherCIGNA
MAJ22840OtherBLUE CROSS BLUE SHIELD