Provider Demographics
NPI:1528000254
Name:ZACHAREAS, MICHAEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:ZACHAREAS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:900 CUMMINGS CTR
Mailing Address - Street 2:STE 117T
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-6183
Mailing Address - Country:US
Mailing Address - Phone:978-232-9400
Mailing Address - Fax:978-232-9405
Practice Address - Street 1:900 CUMMINGS CTR
Practice Address - Street 2:SUITE 117T
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6198
Practice Address - Country:US
Practice Address - Phone:978-232-9400
Practice Address - Fax:978-232-9405
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2020-01-09
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Provider Licenses
StateLicense IDTaxonomies
MA218371208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2026830Medicaid
MAH56980Medicare UPIN
MAH56980Medicare UPIN