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MR. MICHAEL JEROME MICHAELS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
17 OLD ROLLINSFORD RD, SUITE 3, DOVER, NH 03820-2833
(603) 742-5011
(603) 742-3530
Mailing address
271 WASHINGTON RD, RYE, NH 03870-2457
(603) 430-2884

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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