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Individual

HEATHER WARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
548 ELM ST, NORTHAMPTON, MA 01060-2832
(413) 586-3150
(413) 774-7049
Mailing address
548 ELM ST, NORTHAMPTON, MA 01060-2832
(413) 586-3150
(413) 586-6321

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
76508
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
25338
BMC HEALTHNET
MA
05
3143384
MA
01
J16239
BC/BS MA
MA
Enumeration date
08/08/2006
Last updated
04/09/2021
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