1285630970 NPI number — MICHAEL L CUMMINGS M.D.

Table of content: MICHAEL L CUMMINGS M.D. (NPI 1285630970)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285630970 NPI number — MICHAEL L CUMMINGS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CUMMINGS
Provider First Name:
MICHAEL
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285630970
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
97 LIBBEY PARKWAY
Provider Second Line Business Mailing Address:
SUITE 203
Provider Business Mailing Address City Name:
WEYMOUTH
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02189
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-337-3275
Provider Business Mailing Address Fax Number:
781-337-3275

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
97 LIBBEY PKWY STE 203
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEYMOUTH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02189-3110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-337-5680
Provider Business Practice Location Address Fax Number:
781-337-3275
Provider Enumeration Date:
06/27/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  269000 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: MC01342 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2067846 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".