Provider Demographics
NPI:1932410032
Name:SARKAR, AMBER WIEKAMP (MD)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:WIEKAMP
Last Name:SARKAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:F
Other - Last Name:WIEKAMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26 QUEEN ST
Mailing Address - Street 2:FAMILY PRACTICE 2
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01610-2473
Mailing Address - Country:US
Mailing Address - Phone:508-860-7700
Mailing Address - Fax:508-860-7855
Practice Address - Street 1:26 QUEEN ST
Practice Address - Street 2:FAMILY PRACTICE 2
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01610-2473
Practice Address - Country:US
Practice Address - Phone:508-860-7700
Practice Address - Fax:508-860-7855
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA255238207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine