Provider Demographics
NPI:1730130212
Name:CANTOR, MICHAEL D (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:CANTOR
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 1:684 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-1132
Mailing Address - Country:US
Mailing Address - Phone:617-869-2664
Mailing Address - Fax:
Practice Address - Street 1:325 WOOD RD
Practice Address - Street 2:SUITE 210
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-2413
Practice Address - Country:US
Practice Address - Phone:781-356-3336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA79645207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine