Provider Demographics
NPI:1285630970
Name:CUMMINGS, MICHAEL L (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:L
Last Name:CUMMINGS
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 1:97 LIBBEY PARKWAY
Mailing Address - Street 2:SUITE 203
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02189
Mailing Address - Country:US
Mailing Address - Phone:781-337-3275
Mailing Address - Fax:781-337-3275
Practice Address - Street 1:97 LIBBEY PKWY STE 203
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-3110
Practice Address - Country:US
Practice Address - Phone:781-337-5680
Practice Address - Fax:781-337-3275
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA269000208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIMC01342Medicaid
MA2067846Medicaid
MA2067846Medicaid
RI007008159Medicare PIN