Provider Demographics
NPI:1851427116
Name:POZNER, MITCHELL S (MD)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:S
Last Name:POZNER
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 1:876 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:RAYNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02767-1797
Mailing Address - Country:US
Mailing Address - Phone:508-824-9500
Mailing Address - Fax:508-824-9507
Practice Address - Street 1:1215 BROADWAY
Practice Address - Street 2:
Practice Address - City:RAYNHAM
Practice Address - State:MA
Practice Address - Zip Code:02767-1942
Practice Address - Country:US
Practice Address - Phone:508-894-0400
Practice Address - Fax:508-565-0012
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA76032208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3096751Medicaid