Provider Demographics
NPI:1396743399
Name:JUST, HAROLD A (MD)
Entity type:Individual
Prefix:
First Name:HAROLD
Middle Name:A
Last Name:JUST
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:340 MAIN ST
Mailing Address - Street 2:STE 670
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1604
Mailing Address - Country:US
Mailing Address - Phone:508-754-3566
Mailing Address - Fax:508-798-8012
Practice Address - Street 1:825 WASHINGTON ST
Practice Address - Street 2:STE 360
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3441
Practice Address - Country:US
Practice Address - Phone:781-762-0671
Practice Address - Fax:781-762-0671
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2009-04-10
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Provider Licenses
StateLicense IDTaxonomies
MA29622208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0143855Medicaid
MA0143855Medicaid
MAC18039Medicare ID - Type Unspecified