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General NPI Number Information
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NPI Number | 1316138910
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Entity Type | Individual
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Provider Name | MIKHAIL SIGNALOV D.O.
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Gender | Male
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 07/19/2022
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Provider Practice Location Address
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Address Line | 166 KINSLEY ST STE 101
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City | NASHUA
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State | NH
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Zip | 03060-3676
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Country | US
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Telephone | 603-881-7141
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Fax | 603-880-7221
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Provider Business Mailing Address
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Address Line | C/O ST MARY'S HEALTH SYSTEM PO BOX 7291
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City | LEWISTON
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State | ME
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Zip | 04243-7291
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Country | US
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Telephone | 207-777-8695
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Fax | 207-777-8800
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 17234
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License Number State | NH
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