Provider Demographics
NPI:1154575058
Name:MICHAEL V. ELMAN M.D., P.C.
Entity type:Organization
Organization Name:MICHAEL V. ELMAN M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:V
Authorized Official - Last Name:ELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-376-5656
Mailing Address - Street 1:400 WASHINGTON ST STE 206
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-4769
Mailing Address - Country:US
Mailing Address - Phone:617-376-5656
Mailing Address - Fax:
Practice Address - Street 1:400 WASHINGTON ST STE 206
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-4769
Practice Address - Country:US
Practice Address - Phone:617-376-5656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-05
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA235367207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty