Provider Demographics
NPI:1962912030
Name:MICHOL NEGRON DO, PC
Entity type:Organization
Organization Name:MICHOL NEGRON DO, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHOL
Authorized Official - Middle Name:
Authorized Official - Last Name:NEGRON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:781-561-0515
Mailing Address - Street 1:947 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-2313
Mailing Address - Country:US
Mailing Address - Phone:781-561-0515
Mailing Address - Fax:844-366-6142
Practice Address - Street 1:947 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-2313
Practice Address - Country:US
Practice Address - Phone:781-561-0515
Practice Address - Fax:844-366-6142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-03
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA260794207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty