Individual
MR. MICHAEL JEROME MICHAELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
12035
NH
208800000X
Urology Physician
Primary
12035
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01Y005120NH01
BC/BS
NH
05
—
287420099
—
ME
05
—
30204823
—
NH
01
—
7718562
AETNA
NH
01
—
9230227
CIGNA
NH
01
—
G97819
HARVARD PILGRIM
NH
Enumeration date
04/26/2006
Last updated
11/16/2010
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