Healthcare Provider Details

I. General information

NPI: 1437133659
Provider Name (Legal Business Name): MICHAEL J MONZEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 FAIRVIEW AVE STE 221
SKOWHEGAN ME
04976-1481
US

IV. Provider business mailing address

PO BOX 468
SKOWHEGAN ME
04976-0468
US

V. Phone/Fax

Practice location:
  • Phone: 207-474-6945
  • Fax: 207-474-6933
Mailing address:
  • Phone: 207-858-8358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberEL231015
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD11796
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: