Provider Demographics
NPI:1558449868
Name:ALPER, MICHAEL J (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:ALPER
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 1:31 OLD ROUTE 7
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-1711
Mailing Address - Country:US
Mailing Address - Phone:203-885-0808
Mailing Address - Fax:203-885-0813
Practice Address - Street 1:31 OLD ROUTE 7
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-1711
Practice Address - Country:US
Practice Address - Phone:203-885-0808
Practice Address - Fax:203-885-0813
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT022400207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4024972Medicaid
CT060646704OtherTRI-CARE
CT110131809Medicare ID - Type UnspecifiedRAILROAD
CT4024972Medicaid
CT110002045Medicare ID - Type Unspecified
CT060646704OtherTRI-CARE