Provider Demographics
NPI:1457311805
Name:HOWARD, JOHN B (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:B
Last Name:HOWARD
Suffix:
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 1:831 MAIN RD
Mailing Address - Street 2:PRIMA CARE, PC
Mailing Address - City:WESTPORT
Mailing Address - State:MA
Mailing Address - Zip Code:02790-4315
Mailing Address - Country:US
Mailing Address - Phone:508-636-3925
Mailing Address - Fax:508-636-4329
Practice Address - Street 1:831 MAIN RD
Practice Address - Street 2:PRIMA CARE, PC
Practice Address - City:WESTPORT
Practice Address - State:MA
Practice Address - Zip Code:02790-4315
Practice Address - Country:US
Practice Address - Phone:508-636-3925
Practice Address - Fax:508-636-4329
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA30075207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0140996Medicaid
MAB47106Medicare ID - Type Unspecified
MA0140996Medicaid
MAB4710601Medicare PIN