Individual
COREY MICHELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-1000
Mailing address
281 LINCOLN ST, PROVIDER ENROLLMENT, WORCESTER, MA 01655-0002
(774) 366-9653
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
1022151
MA
Other
Enumeration date
03/30/2022
Last updated
05/06/2025
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