Provider Demographics
NPI:1134165111
Name:WORKUM, FIFIELD PETER JR (MD)
Entity type:Individual
Prefix:DR
First Name:FIFIELD
Middle Name:PETER
Last Name:WORKUM
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:F.
Other - Middle Name:PETER
Other - Last Name:WORKUM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:50 MEMORIAL DR
Mailing Address - Street 2:SUITE #113
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-2238
Mailing Address - Country:US
Mailing Address - Phone:978-537-0296
Mailing Address - Fax:978-466-4250
Practice Address - Street 1:50 MEMORIAL DR
Practice Address - Street 2:SUITE #113
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2238
Practice Address - Country:US
Practice Address - Phone:978-537-0296
Practice Address - Fax:978-466-4250
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA37939207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA037939OtherTUFTS INSURANCE
MA5071OtherFALLON
MAMEDICAIDMedicaid
MAV46210OtherNETWORK HEALTH
MA60823OtherHARVARD PILGRIM
MA5071OtherFALLON
MAM09009Medicare ID - Type UnspecifiedMEDICARE