Provider Demographics
NPI:1871807479
Name:WARDROP, RICHARD MARK (NP)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:MARK
Last Name:WARDROP
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20 CLAFLIN ST.
Mailing Address - Street 2:BLAIRE HOUSE
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-4006
Mailing Address - Country:US
Mailing Address - Phone:508-473-1272
Mailing Address - Fax:508-634-3943
Practice Address - Street 1:20 CLAFLIN ST.
Practice Address - Street 2:BLAIRE HOUSE
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-4006
Practice Address - Country:US
Practice Address - Phone:508-473-1272
Practice Address - Fax:508-634-3943
Is Sole Proprietor?:No
Enumeration Date:2010-08-06
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA134021363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health