Healthcare Provider Details

I. General information

NPI: 1639373517
Provider Name (Legal Business Name): MICHEL LIRETTE, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 01/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 TURNPIKE ST STE 115
NORTH ANDOVER MA
01845-5072
US

IV. Provider business mailing address

203 TURNPIKE ST SUITE 115
NORTH ANDOVER MA
01845-5042
US

V. Phone/Fax

Practice location:
  • Phone: 978-681-4505
  • Fax: 978-681-4507
Mailing address:
  • Phone: 978-474-0922
  • Fax: 978-681-4507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number76941
License Number StateMA

VIII. Authorized Official

Name: DR. MICHEL LIRETTE
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 978-681-4505