Provider Demographics
NPI:1467544858
Name:PRICE, MICHAEL JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JAY
Last Name:PRICE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:578 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-3900
Mailing Address - Country:US
Mailing Address - Phone:781-321-6544
Mailing Address - Fax:781-321-6172
Practice Address - Street 1:578 MAIN ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-3900
Practice Address - Country:US
Practice Address - Phone:781-321-6544
Practice Address - Fax:781-321-6172
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA53026207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ03282OtherMEDICARE
MA0004093OtherNEIGHBORHOOD HEALTH PLAN
MA708937OtherTUFTS HEALTH PLAN
MA9755764Medicaid
MA15498OtherHARVARD PILGRIM HEALTH CARE
MA000000021744OtherBMC HEALTHNET
MA31042OtherFALLON COMMUNITY HEALTH PLAN
MA6177468Medicaid
MA991934OtherNETWORK HEALTH
MAJ03282OtherBLUE SHIELD
3017518OtherCIGNA HEALTHCARE
180005630OtherRAILROAD MEDICARE
MA8441OtherAETNA U.S. HEALTHCARE
MA8441OtherAETNA U.S. HEALTHCARE
MA31042OtherFALLON COMMUNITY HEALTH PLAN