Individual
MICHAEL J.F. IANNESSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1233 STATE RD, PLYMOUTH, MA 02360-5133
(508) 224-7701
Mailing address
40 CHESTNUT ST, APT. #2, CHARLESTOWN, MA 02129-3436
(781) 254-1148
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
52862
MA
207V00000X
Obstetrics & Gynecology Physician
52862
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3136248
—
MA
Enumeration date
07/18/2006
Last updated
05/31/2012
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