Provider Demographics
NPI:1215998372
Name:MCINERNEY, MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:MCINERNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 NORTH ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4147
Mailing Address - Country:US
Mailing Address - Phone:413-499-8510
Mailing Address - Fax:
Practice Address - Street 1:777 NORTH ST
Practice Address - Street 2:SUITE 207
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4147
Practice Address - Country:US
Practice Address - Phone:413-499-8510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA52752207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA043531502OtherNORTH AMERICAN HEALTH
MA14302OtherHEALTH NEW ENGLAND
MA043531502OtherCIGNA INDEMNITY
MA3009122Medicaid
MA01673014Other01673014
MA346303OtherMVP
MA000000020928OtherHEALTHNET
MA043531502OtherNEIGHBORHOOD HEALTH PLAN
MA052752OtherTUFTS
MA3871912OtherCIGNA/HEALTHSOURCE
MAA57070OtherHARVARD
MA043531502OtherHMC PPO
MA043531502OtherUHC
MAJ03573OtherBCBS
MA043531502OtherGIC INDEMNITY
MA10034389OtherCDCHP
MA110213857OtherRAILROAD MEDICARE
MAA57070Medicare UPIN
MAJ03573Medicare ID - Type Unspecified