Individual
DR. MICHAEL LOUIS SQUIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2624 RIDGEWAY CIR, JONES, OK 73049-4971
(630) 297-5302
Mailing address
2624 RIDGEWAY CIR, JONES, OK 73049-4971
(630) 297-5302
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
M-13157
ID
2085B0100X
Body Imaging Physician
MD60461265
WA
2085R0202X
Diagnostic Radiology Physician
072452
GA
2085R0202X
Diagnostic Radiology Physician
M-13157
ID
2085R0202X
Diagnostic Radiology Physician
Primary
MD60461265
WA
2085R0204X
Vascular & Interventional Radiology Physician
M-13157
ID
2085R0204X
Vascular & Interventional Radiology Physician
MD60461265
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0353429
L&I-RADIA REST OF WA
WA
01
—
0353469
L&I-RADIA KING CTY
WA
01
—
0353470
L&I-SWEDISH RADIA EDMONDS
WA
01
—
0353472
L&I-EVERGREEN RADIA
WA
01
—
0385157
L&I-SOUTH SOUND RADIOLOGY
WA
01
—
0405139
L&I-SEATTLE RADIOLOGY
WA
05
—
1356592943
—
ID
05
—
2044272
—
WA
Enumeration date
10/01/2008
Last updated
09/25/2023
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