Provider Demographics
NPI:1457311011
Name:BUCHWALD, IRWIN A (MD)
Entity Type:Individual
Prefix:
First Name:IRWIN
Middle Name:A
Last Name:BUCHWALD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6 LANCASTER COUNTY ROAD
Mailing Address - Street 2:SUITE # 6
Mailing Address - City:HARVARD
Mailing Address - State:MA
Mailing Address - Zip Code:01451
Mailing Address - Country:US
Mailing Address - Phone:978-772-9797
Mailing Address - Fax:888-373-2472
Practice Address - Street 1:ONE HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852
Practice Address - Country:US
Practice Address - Phone:978-934-8319
Practice Address - Fax:978-459-2876
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA35122207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9726373Medicaid
A34606Medicare UPIN
MA9726373Medicaid