Provider Demographics
NPI:1598850851
Name:NEMETH, GEORGE WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:WILLIAM
Last Name:NEMETH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 598
Mailing Address - Street 2:
Mailing Address - City:HARWICH PORT
Mailing Address - State:MA
Mailing Address - Zip Code:02646-0598
Mailing Address - Country:US
Mailing Address - Phone:508-905-2800
Mailing Address - Fax:774-209-3227
Practice Address - Street 1:710 MAIN ST
Practice Address - Street 2:
Practice Address - City:HARWICH PORT
Practice Address - State:MA
Practice Address - Zip Code:02646-1931
Practice Address - Country:US
Practice Address - Phone:508-432-1400
Practice Address - Fax:508-487-6298
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA38354207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA56415Medicare UPIN