Provider Demographics
NPI:1174682314
Name:COMPAIN, MICHAEL H (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:H
Last Name:COMPAIN
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 1:50 OLD FARM RD
Mailing Address - Street 2:
Mailing Address - City:RED HOOK
Mailing Address - State:NY
Mailing Address - Zip Code:12571-1633
Mailing Address - Country:US
Mailing Address - Phone:845-758-0001
Mailing Address - Fax:845-758-0022
Practice Address - Street 1:50 OLD FARM RD
Practice Address - Street 2:
Practice Address - City:RED HOOK
Practice Address - State:NY
Practice Address - Zip Code:12571-1633
Practice Address - Country:US
Practice Address - Phone:845-758-0001
Practice Address - Fax:845-758-0022
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY130291-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB20260Medicare UPIN
NY55625AMedicare ID - Type Unspecified
NY94A622Medicare ID - Type Unspecified