Healthcare Provider Details
I. General information
NPI: 1215134325
Provider Name (Legal Business Name): MICHAEL J. REGAN IV MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/02/2007
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
800 WASHINGTON ST
NORWOOD MA
02062-3487
US
IV. Provider business mailing address
62 LENOX DR
FRANKLIN MA
02038-1189
US
V. Phone/Fax
- Phone: 781-769-4000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RB0002X |
| Taxonomy | Obesity Medicine (Internal Medicine) Physician |
| License Number | 89997183 |
| License Number State | MA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083B0002X |
| Taxonomy | Obesity Medicine (Preventive Medicine) Physician |
| License Number | 89997183 |
| License Number State | MA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | 238929 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: