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NPI Code Detail

MEDICARE: GIANMICHEL D CORRADO M.D.

MEDICARE: GIANMICHEL D CORRADO M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207PS0010XSports Medicine (Emergency Medicine) Physician212795MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316020712
Entity Type Code : Individual
Provider Name (Legal Business Name) : GIANMICHEL D CORRADO M.D.
Provider Business Mailing Address
First Line : 319 LONGWOOD AVE
Second Line : 6TH FLOOR
City : BOSTON
State : MA
Zip : 02115-5728
Country : US
Telephone Number : 617-355-6028
Fax Number : 617-731-5298
Provider Business Practice Location Address
First Line : 319 LONGWOOD AVE
Second Line : 6TH FLOOR
City : BOSTON
State : MA
Zip : 02115-5728
Country : US
Telephone Number : 617-355-6028
Fax Number : 617-731-5298
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2006
Last Update Date : 10/30/2009

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