Provider Demographics
NPI:1992798383
Name:GLAIEL, MICHAEL JUDE (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JUDE
Last Name:GLAIEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 431
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01073-0431
Mailing Address - Country:US
Mailing Address - Phone:413-527-9903
Mailing Address - Fax:413-527-9904
Practice Address - Street 1:166 COLLEGE HWY
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01073-9272
Practice Address - Country:US
Practice Address - Phone:413-527-9903
Practice Address - Fax:413-527-9904
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA763111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0849709001OtherCIGNA
MA35692OtherHARVARD PILGRAM
MA407099OtherTUFTS
MA665304OtherACN
MA0781862OtherAETNA
MAY35657OtherBC/BS
MA0781862OtherAETNA