Provider Demographics
NPI:1346209665
Name:NEGRON, MICHOL (DO)
Entity Type:Individual
Prefix:
First Name:MICHOL
Middle Name:
Last Name:NEGRON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-3028
Mailing Address - Country:US
Mailing Address - Phone:781-561-0515
Mailing Address - Fax:844-366-6142
Practice Address - Street 1:20 BURLINGTON MALL RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803
Practice Address - Country:US
Practice Address - Phone:781-561-0515
Practice Address - Fax:844-366-6142
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA260794207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine