Provider Demographics
NPI:1598727117
Name:LIRETTE, MICHEL (MD)
Entity Type:Individual
Prefix:
First Name:MICHEL
Middle Name:
Last Name:LIRETTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:203 TURNPIKE STREET
Mailing Address - Street 2:SUITE 115
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845
Mailing Address - Country:US
Mailing Address - Phone:978-681-4505
Mailing Address - Fax:978-681-4507
Practice Address - Street 1:203 TURNPIKE STREET
Practice Address - Street 2:SUITE 115
Practice Address - City:N ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845
Practice Address - Country:US
Practice Address - Phone:978-681-4505
Practice Address - Fax:978-681-4507
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA76941207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
130002OtherHARVARD PILGRIM
3110541OtherMASS HEALTH
MAJ13903OtherBLUE SHIELD
MA730461OtherTUFTS HEALTH PLAN
043429157OtherTAX ID
2008823OtherAETNA US HEALTHCARE
MA9784802Medicaid
981320OtherNETWORK HEALTH CARE
0017405OtherNEIGHBORHOOD HEALTH PLAN
NH0100631Y0MA01OtherBLUE SHIELD
0700834OtherUNITED HEALTH CARE
730461OtherTUFTS
MAM17018OtherBLUE SHIELD
MAJ13903OtherBLUE SHIELD
981320OtherNETWORK HEALTH CARE
MA9784802Medicaid