Provider Demographics
NPI:1023290939
Name:MICHAEL E. MIGLIORI, MD FACS, LTD
Entity type:Organization
Organization Name:MICHAEL E. MIGLIORI, MD FACS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:MIGLIORI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-274-6622
Mailing Address - Street 1:120 DUDLEY ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-2436
Mailing Address - Country:US
Mailing Address - Phone:401-274-6622
Mailing Address - Fax:401-490-7051
Practice Address - Street 1:120 DUDLEY ST
Practice Address - Street 2:SUITE 301
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-2436
Practice Address - Country:US
Practice Address - Phone:401-274-6622
Practice Address - Fax:401-490-7051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD07071207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty