Provider Demographics
NPI:1376523621
Name:CAMPBELL, MICHAEL A (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:191 BEDFORD ST
Mailing Address - Street 2:5TH FLR
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-3011
Mailing Address - Country:US
Mailing Address - Phone:508-235-5445
Mailing Address - Fax:
Practice Address - Street 1:191 BEDFORD ST
Practice Address - Street 2:MILLVIEW MEDICAL ASSOCIATES, 5TH FLR
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3011
Practice Address - Country:US
Practice Address - Phone:508-235-5445
Practice Address - Fax:508-235-5786
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2008-07-29
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Provider Licenses
StateLicense IDTaxonomies
GA052153207Q00000X
MA234513207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2200020Medicare PIN