Provider Demographics
NPI:1205374220
Name:CORDEIRO, MICHAEL JOSEPH
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:CORDEIRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1879 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:DIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02715-1008
Mailing Address - Country:US
Mailing Address - Phone:508-332-2122
Mailing Address - Fax:
Practice Address - Street 1:1879 SMITH ST
Practice Address - Street 2:
Practice Address - City:DIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02715-1008
Practice Address - Country:US
Practice Address - Phone:508-332-2122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program