Provider Demographics
NPI:1972003366
Name:HARTWELL, NATHAN HAYWOOD (PHARMD MPH BCOP)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:HAYWOOD
Last Name:HARTWELL
Suffix:
Gender:M
Credentials:PHARMD MPH BCOP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 BURLINGTON MALL RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01805-0001
Mailing Address - Country:US
Mailing Address - Phone:781-744-2341
Mailing Address - Fax:
Practice Address - Street 1:LAHEY HOSPITAL AND MEDICAL CENTER
Practice Address - Street 2:41 BURLINGTON MALL RD
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01805-0180
Practice Address - Country:US
Practice Address - Phone:781-744-2341
Practice Address - Fax:781-744-2341
Is Sole Proprietor?:No
Enumeration Date:2018-02-13
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH2325141835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPH232514OtherREGISTERED PHARMACIST