Individual
CHARLES M WICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
233 LINCOLN AVE, HAVERHILL, MA 01830-6738
(978) 374-1010
(978) 556-0568
Mailing address
LAHEY CLINIC, 41 MALL ROAD, BURLINGTON, MA 01805-0001
(978) 374-1010
(978) 556-0568
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
49128
MA
207RP1001X
Pulmonary Disease Physician
Primary
49128
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0161772
—
MA
Enumeration date
09/28/2006
Last updated
06/09/2010
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