Harrison, David Wayne

Harrison, David Wayne is an individual health care provider with primary practice located at 19 Norwood St , Everett MA 02149-2709. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Harrison, David Wayne can be contacted via phone (617) 394-7500.

Contact Information

Primary practice address
19 Norwood St Everett MA 02149-2709
Phone: (617) 394-7500
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 216239 Massachusetts
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 216239 Massachusetts

Profile Details

NPI number 1790775369
LBN Legal business name Harrison, David Wayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2005
Last updated Mar 20th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790775369 NPPES
Massachusetts Other J28526 BCBS MA
Massachusetts Other 468008 BCBS MA
Massachusetts MEDICAID 2100134 BCBS MA

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