Individual
DR. MARC DROR MICHAELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
55 FRUIT ST, COX 640 HEMATOLOGY ONCOLOGY, BOSTON, MA 02114-2621
(617) 726-5187
(617) 724-3166
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-1594
(617) 726-3440
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
159790
MA
207RX0202X
Medical Oncology Physician
Primary
159790
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0169391
—
MA
01
—
159790
TUFTS HEALTH PLAN
MA
01
—
J24713
BCBS MA
MA
Enumeration date
10/27/2005
Last updated
01/28/2026
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