Provider Demographics
NPI:1295703783
Name:SARGENT, WILLIAM M (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:M
Last Name:SARGENT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:525 LONG POND DR
Mailing Address - Street 2:FONTAINE MEDICAL CENTER
Mailing Address - City:HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02645
Mailing Address - Country:US
Mailing Address - Phone:508-432-4100
Mailing Address - Fax:508-432-8951
Practice Address - Street 1:525 LONG POND DR
Practice Address - Street 2:FONTAINE MEDICAL CENTER
Practice Address - City:HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02645
Practice Address - Country:US
Practice Address - Phone:508-432-4100
Practice Address - Fax:508-432-8951
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA159337207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ21905OtherBCBS
MA3051749Medicaid
MA710727OtherHPHC
D03300Medicare UPIN
MA710727OtherHPHC