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Individual

DR. MICHIEL M DEMOOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
800 WASHINGTON ST # 313, TUFTS MEDICAL CENTER, BOSTON, MA 02111-1552
(617) 636-5067
(617) 636-2354
Mailing address
800 WASHINGTON ST # 313, TUFTS MEDICAL CENTER, BOSTON, MA 02111-1552
(617) 636-5067
(617) 636-2354

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
160252
MA
2080P0202X
Pediatric Cardiology Physician
Primary
160252
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3164616
MA
01
764607
TUFTS HEALTH PLAN
MA
01
J17454
BCBS MA
MA
Enumeration date
03/09/2006
Last updated
03/30/2010
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