Provider Demographics
NPI:1790944403
Name:CARTWRIGHT, MICHAEL SR (C-PED)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:CARTWRIGHT
Suffix:SR
Gender:M
Credentials:C-PED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 E MAIN ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:CLINTON
Mailing Address - State:CT
Mailing Address - Zip Code:06413-2245
Mailing Address - Country:US
Mailing Address - Phone:860-664-3664
Mailing Address - Fax:860-399-4726
Practice Address - Street 1:246 E MAIN ST
Practice Address - Street 2:UNIT 1
Practice Address - City:CLINTON
Practice Address - State:CT
Practice Address - Zip Code:06413-2245
Practice Address - Country:US
Practice Address - Phone:860-664-3664
Practice Address - Fax:860-399-4726
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier