Organization
MICHAEL K GAVIGAN DPM
Active
Parent organization
MICHAEL K GAVIGAN DPM
Organization subpart
Yes
Provider details
NPI number
Legal business name
MICHAEL K GAVIGAN DPM
Authorized official
SANDRA MICHELLE WRIGHT (OFFICE MANAGER)
(508) 563-7133
Entity
Organization
Contact information
Practice address
4 BARLOWS LANDING RD, #17, POCASSET, MA 02559-1980
(508) 563-7133
(508) 563-6771
Mailing address
4 BARLOWS LANDING RD STE 17, P.O BOX 3227, POCASSET, MA 02559-1984
(508) 563-7133
(508) 563-6771
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
1770
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0361704
—
MA
01
—
1588779607
NPI
MA
01
—
4416070001
DMERC
MA
01
—
Y70831
BLE CROSS
—
Enumeration date
12/10/2007
Last updated
04/20/2008
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