Provider Demographics
NPI:1902863152
Name:SEARS, MICHAEL (DPM)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:SEARS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 SEMINOLE AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07436-2912
Mailing Address - Country:US
Mailing Address - Phone:201-225-4700
Mailing Address - Fax:201-225-4702
Practice Address - Street 1:230 E RIDGEWOOD AVE
Practice Address - Street 2:SUITE 6 2
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-4131
Practice Address - Country:US
Practice Address - Phone:201-225-4700
Practice Address - Fax:201-225-4702
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00185000213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T81568Medicare UPIN
546315Medicare ID - Type Unspecified