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Individual

MICHEL-ANGE FERDINAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
115 JEFFERSON AVE, ELIZABETH, NJ 07201
(908) 351-6663
(903) 351-1760
Mailing address
115 JEFFERSON AVE, PO BOX 470, ELIZABETH, NJ 07201
(908) 351-6663
(903) 351-1760

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA41866
NJ
207Q00000X
Family Medicine Physician
ME62196
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8654506
NJ
Enumeration date
09/07/2006
Last updated
05/13/2009
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