Organization
SHENOUDA CORP
Active
Other names
Michael Mitry, DPM
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MITRY DPM (PODIATRIST)
(508) 361-0078
Entity
Organization
Contact information
Practice address
1410 HIGHLAND AVE STE 204, NEEDHAM, MA 02492
(781) 444-4044
(781) 444-5044
Mailing address
1410 HIGHLAND AVE STE 204, NEEDHAM, MA 02492-2617
(781) 444-4044
(781) 444-5044
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110109398C
—
MA
Enumeration date
03/02/2015
Last updated
11/27/2018
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