Provider Demographics
NPI:1578526430
Name:NOONAN, MICHAEL ALLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALLEN
Last Name:NOONAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 PLEASANT STREET
Mailing Address - Street 2:
Mailing Address - City:BRUMSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011
Mailing Address - Country:US
Mailing Address - Phone:207-725-7177
Mailing Address - Fax:207-827-0260
Practice Address - Street 1:9 PLEASANT STREET
Practice Address - Street 2:
Practice Address - City:BRUMSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011
Practice Address - Country:US
Practice Address - Phone:207-725-7177
Practice Address - Fax:207-827-0260
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR589171100000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MET31442Medicare UPIN
MEME0709Medicare ID - Type Unspecified