Provider Demographics
NPI:1134268782
Name:TING, MICHAEL K (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:K
Last Name:TING
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 1:12 HIGH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7634
Mailing Address - Country:US
Mailing Address - Phone:207-795-5770
Mailing Address - Fax:
Practice Address - Street 1:12 HIGH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7634
Practice Address - Country:US
Practice Address - Phone:207-795-5770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME017200207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME433301299Medicaid
ME433301299Medicaid