Healthcare Provider Details

I. General information

NPI: 1982608956
Provider Name (Legal Business Name): MICHAEL J MEUTH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2005
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1565 NORTH MAIN STREET SUITE 306
FALL RIVER MA
02720-2972
US

IV. Provider business mailing address

200 MILL ROAD SUITE 180
FAIRHAVEN MA
02719-5252
US

V. Phone/Fax

Practice location:
  • Phone: 508-973-9500
  • Fax: 508-973-0351
Mailing address:
  • Phone: 508-973-2000
  • Fax: 508-973-2001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number159159
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: