Healthcare Provider Details

I. General information

NPI: 1477547487
Provider Name (Legal Business Name): MICHAEL DAVID POPITZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2005
Last Update Date: 02/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 PAGE ST
NEW BEDFORD MA
02740-3464
US

IV. Provider business mailing address

64 INDIAN COVE RD
MARION MA
02738-2113
US

V. Phone/Fax

Practice location:
  • Phone: 508-997-1515
  • Fax: 508-997-2417
Mailing address:
  • Phone: 617-435-1016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number58908
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: