Individual
DR. JOHN HALLOCK OLDERSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
85 HERRICK ST, BEVERLY, MA 01915-1776
(978) 922-3000
Mailing address
2527 CRANBERRY HIGHWAY, ATTN: NANCI KARDOS-CARLL/PROVIDER RELATIONS DEPT., WAREHAM, MA 02571-1046
(800) 841-5200
(508) 273-1241
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
72783
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3070786
—
MA
Enumeration date
05/31/2005
Last updated
07/20/2012
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