Provider Demographics
NPI:1699378802
Name:WARD, MATTHEW A (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:A
Last Name:WARD
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-2541
Mailing Address - Country:US
Mailing Address - Phone:781-272-4146
Mailing Address - Fax:781-270-3634
Practice Address - Street 1:242 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-2541
Practice Address - Country:US
Practice Address - Phone:781-272-4146
Practice Address - Fax:781-270-3634
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH234090183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist