MEDICARE: MR. MICHAEL P JOSEPH MD

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
1	207Y00000X	Otolaryngology Physician	017611	ME

Other Identifiers

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

General Provider Information

NPI Number	:	1629086657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL P JOSEPH MD

Provider Business Mailing Address
First Line	:	21 MAIN ST
Second Line	:
City	:	LIVERMORE FALLS
State	:	ME
Zip	:	04254-1219
Country	:	US
Telephone Number	:	207-897-6601
Fax Number	:	207-897-4339

Provider Business Practice Location Address
First Line	:	105 MT BLUE CIR
Second Line	:	SUITE 2
City	:	FARMINGTON
State	:	ME
Zip	:	04938-6239
Country	:	US
Telephone Number	:	207-779-2640
Fax Number	:	207-779-2642

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	05/01/2013

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