Provider Demographics
NPI:1861469751
Name:DALEY, MICHAEL J (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:DALEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:630 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605
Mailing Address - Country:US
Mailing Address - Phone:508-898-2338
Mailing Address - Fax:508-366-9938
Practice Address - Street 1:900 UNION ST
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-5408
Practice Address - Country:US
Practice Address - Phone:508-898-2338
Practice Address - Fax:508-366-9938
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA49493208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
917638OtherFIRST HEALTH
042472266OtherHEALTHCARE VALUE MANAGEME
0776210OtherCIGNA HEALTH PLAN
26737OtherHEALTHY START
5459371OtherAETNA US HEALTHCARE
MA110051949AMedicaid
J02512OtherBLUE SHIELD INDEMNITY
042472266OtherONE HEALTH PLAN
042472266OtherTRICARE CHAMPUS
3099245OtherMEDICAID WELFARE
042472266OtherPRIVATE HEALTHCARE SYSTEM
042472266OtherTHREE RIVERS
9900120OtherFALLON COMMUNITY HEALTH
J02512OtherBLUE SHIELD HMO BLUE
26737OtherCHILDRENS MEDICAL SECURIT
784124OtherMVP HEALTH CARE
A02512OtherMEDICARE B
AA1257OtherHARVARD PILGRIM HEALTHCAR
J02512OtherBLUE CARE ELECT
MA3099245Medicaid