Provider Demographics
NPI:1962533380
Name:LEMAY, MICHAEL JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JAMES
Last Name:LEMAY
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 1:301 MILL POND DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-3595
Mailing Address - Country:US
Mailing Address - Phone:860-648-1281
Mailing Address - Fax:
Practice Address - Street 1:460 HARTFORD TPKE
Practice Address - Street 2:SUITE A
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-4845
Practice Address - Country:US
Practice Address - Phone:860-896-4877
Practice Address - Fax:860-896-4876
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA221122207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
I14949Medicare UPIN