| Doctor Name: | PHILIP FORMICA |
| NPI Number: | 1184883209 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 256905 |
| Business Practice Address: | 208 Mill Rd Fairhaven, MA - 027195208 |
| Business Phone Number: | 5089732207 |
| Business Fax Number: | 5089732505 |
| Mailing Address: | 200 Mill Rd Ste 180, FAIRHAVEN |
| State: | MA |
| Postal Code: | 027195255 |
| Phone Number: | 5089732000 |
| Fax Number: | 5089732001 |
| NPI Enumeration Date: | 06/04/2008 |
| NPI Last Update Date: | 02/11/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RC0000X |
| License Number: | 256905 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Cardiovascular Disease |
| Taxonomy Definition: | An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |