Basic Information
Provider Information
NPI: 1144461153
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NORWOOD
FirstName: BRENDAN
MiddleName: ROWAN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8 OAKVIEW TER
Address2: APT #2
City: JAMAICA PLAIN
State: MA
PostalCode: 021304902
CountryCode: US
TelephoneNumber: 6462621808
FaxNumber:  
Practice Location
Address1: 85 HERRICK ST
Address2: EMERGENCY MEDICINE
City: BEVERLY
State: MA
PostalCode: 019151790
CountryCode: US
TelephoneNumber: 9789223000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/20/2009
LastUpdateDate: 07/29/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X254367MAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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