Individual
JUSTIN C. HARVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 421-1400
(508) 421-1490
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
277929
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110118832A
—
MA
Enumeration date
03/27/2016
Last updated
02/08/2019
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