Individual
MICHELLE L. LOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
92 MONTVALE AVE, SUITE 4200, STONEHAM, MA 02180-3647
(781) 451-0072
(781) 451-0073
Mailing address
92 MONTVALE AVE, SUITE 4200, STONEHAM, MA 02180-3647
(781) 451-0072
(781) 451-0073
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
226036
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0036396
NEIGHBORHOOD HEALTH PLAN
MA
01
—
226036
STATE LICENSE
MA
01
—
494236
TUFTS HEALTH PLAN
MA
01
—
AA44091
HARVARD PILGRIM
MA
01
—
J29376
BLUE CROSS/BLUE SHIELD
MA
Enumeration date
04/13/2006
Last updated
03/07/2023
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