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Individual

DR. MICHAEL K GAVIGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
4 BARLOWS LANDING RD, SUITE #17, POCASSET, MA 02559-1980
(508) 563-7133
(508) 563-6771
Mailing address
PO BOX 3227, SUITE #17, POCASSET, MA 02559-3227
(508) 563-7133

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
1770
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0361704
MEDICAID
MA
01
1588779607
BCBS
01
27-07976
EVERCARE
NJ
01
33081
HPHC
MA
01
710223
TUFTS
MA
Enumeration date
08/20/2006
Last updated
09/04/2013
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