Individual
MICHAEL IANNAMORELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(774) 475-0831
(508) 856-4224
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
266760
MA
208600000X
Surgery Physician
OS022075
PA
2086S0102X
Surgical Critical Care Physician
Primary
287397
MA
2086S0102X
Surgical Critical Care Physician
OS022075
PA
2086S0127X
Trauma Surgery Physician
287397
MA
Other
Enumeration date
05/10/2016
Last updated
01/22/2024
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