Provider Demographics
NPI:1205147543
Name:RODRIGUEZ, MICHELLE ROBIN (MAOM)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ROBIN
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 CHADDERTON WAY
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-3069
Mailing Address - Country:US
Mailing Address - Phone:508-294-1526
Mailing Address - Fax:
Practice Address - Street 1:37 CHADDERTON WAY
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-3069
Practice Address - Country:US
Practice Address - Phone:508-294-1526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist