Individual
MICHAEL O. AZZONI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
250 GREEN ST, GARDNER, MA 01440-1396
(978) 632-0383
(978) 632-0714
Mailing address
250 GREEN ST, GARDNER, MA 01440-1396
(978) 632-0383
(978) 632-0714
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
151384
MA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
151384
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3170837
—
MA
Enumeration date
09/30/2005
Last updated
09/24/2013
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