Provider Demographics
NPI:1710163944
Name:LAROCHELLE, MICHAEL F (DO)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:F
Last Name:LAROCHELLE
Suffix:
Gender:M
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:60 HOSPITAL RD
Mailing Address - Street 2:WACHUSETT EMERGENCY PHYSICIANS
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453
Mailing Address - Country:US
Mailing Address - Phone:978-466-2995
Mailing Address - Fax:978-466-2993
Practice Address - Street 1:60 HOSPITAL RD
Practice Address - Street 2:WACHUSETT EMERGENCY PHYSICIANS
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453
Practice Address - Country:US
Practice Address - Phone:978-466-2995
Practice Address - Fax:978-466-2993
Is Sole Proprietor?:No
Enumeration Date:2008-01-17
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ00000000000000001208D00000X
MA235531207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110100079AMedicaid
MA110100079AMedicaid