Provider Demographics
NPI:1336269281
Name:MASTER, MICHAEL J (DC, DACNB)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:MASTER
Suffix:
Gender:M
Credentials:DC, DACNB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:445 HURFFVILLE CROSSKEYS RD
Mailing Address - Street 2:SUITE A13
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2337
Mailing Address - Country:US
Mailing Address - Phone:856-256-8840
Mailing Address - Fax:856-256-0951
Practice Address - Street 1:445 HURFFVILLE CROSSKEYS RD
Practice Address - Street 2:SUITE A13
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2337
Practice Address - Country:US
Practice Address - Phone:856-256-8840
Practice Address - Fax:856-256-0951
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC004884111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ661823Medicare ID - Type Unspecified