Organization
JOSEPH M DE MICHELE MD FACS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH M DE MICHELE MD (PRESIDENT)
(781) 595-0998
Entity
Organization
Contact information
Practice address
190 OCEAN STREET, LYNN, MA 01902
(781) 595-0998
Mailing address
190 OCEAN STREET, LYNN, MA 01902
(781) 595-0998
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
25542
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17765
HARVARD PILGRIM
—
01
—
706020
TUFTS
—
Enumeration date
08/14/2006
Last updated
04/20/2008
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