Healthcare Provider Details

I. General information

NPI: 1144317066
Provider Name (Legal Business Name): MICHAEL HOSKINS TECHNICIANS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COMDT (CG-1122), U.S. COAST GUARD 2100 2ND ST SW, SUITE 5314
WASHINGTON, DC DC
20593
US

IV. Provider business mailing address

5201 LEE RD
BUZZARDS BAY MA
02542-1313
US

V. Phone/Fax

Practice location:
  • Phone: 508-968-6579
  • Fax:
Mailing address:
  • Phone: 508-968-6579
  • Fax: 508-968-6571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number24720000X
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: