Healthcare Provider Details

I. General information

NPI: 1104850858
Provider Name (Legal Business Name): MIGUEL A ARIZA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 10/26/2020
Certification Date: 10/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 LOON HILL RD STE 301
DRACUT MA
01826-4365
US

IV. Provider business mailing address

9 LOON HILL ROD SUITE 301
DRACUT MA
01826
US

V. Phone/Fax

Practice location:
  • Phone: 978-323-0360
  • Fax: 978-323-0362
Mailing address:
  • Phone: 978-323-0360
  • Fax: 978-323-0362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number229858
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: