Provider Demographics
NPI:1104850858
Name:ARIZA, MIGUEL A (MD)
Entity Type:Individual
Prefix:
First Name:MIGUEL
Middle Name:A
Last Name:ARIZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 LOON HILL ROD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826
Mailing Address - Country:US
Mailing Address - Phone:978-323-0360
Mailing Address - Fax:978-323-0362
Practice Address - Street 1:9 LOON HILL RD STE 301
Practice Address - Street 2:
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-4365
Practice Address - Country:US
Practice Address - Phone:978-323-0360
Practice Address - Fax:978-323-0362
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA229858207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000129401Medicare PIN