Individual
MR. MICAH JARRETT DORIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, BSN
Contact information
Practice address
26 SOUTHWICK ST APT 1, SALEM, MA 01970-2515
(617) 335-9779
Mailing address
26 SOUTHWICK ST APT 1, SALEM, MA 01970-2515
(617) 335-9779
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
MA276465
MA
Other
Enumeration date
02/24/2012
Last updated
02/24/2012
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