Provider Demographics
NPI:1972604387
Name:FINEGAN, MICHAEL B (PHD)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:B
Last Name:FINEGAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1119
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:MD
Mailing Address - Zip Code:21810-1119
Mailing Address - Country:US
Mailing Address - Phone:410-546-5455
Mailing Address - Fax:
Practice Address - Street 1:102 W MARKET ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-4933
Practice Address - Country:US
Practice Address - Phone:410-860-2673
Practice Address - Fax:410-860-0450
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1000182103TC0700X
DEB1-0000658103TC0700X
MD01935103TC0700X
VA0810003244103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD843LMedicare PIN