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General NPI Number Information
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NPI Number | 1093761793
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Entity Type | Individual
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Provider Name | MICHAEL W TREMBLAY D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 03/07/2013
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Provider Practice Location Address
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Address Line | 175 N FRANKLIN ST
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City | HOLBROOK
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State | MA
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Zip | 02343-1171
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Country | US
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Telephone | 781-767-0910
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Fax | 781-767-9019
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Provider Business Mailing Address
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Address Line | 175 N FRANKLIN ST
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City | HOLBROOK
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State | MA
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Zip | 02343-1171
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Country | US
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Telephone | 781-767-0910
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Fax | 781-767-9019
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 71932
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License Number State | MA
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