Individual
MICHAEL MITRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1410 HIGHLAND AVE STE 204, NEEDHAM, MA 02492-4460
(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
2384
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110103207A
—
MA
Enumeration date
09/02/2010
Last updated
01/26/2022
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