Provider Demographics
NPI:1396726113
Name:HURWITZ, MICHAEL E (MD PHD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:E
Last Name:HURWITZ
Suffix:
Gender:M
Credentials:MD PHD
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Mailing Address - Street 1:333 CEDAR ST
Mailing Address - Street 2:YALE UNIVERSITY SCHOOL OF MEDICINE
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3206
Mailing Address - Country:US
Mailing Address - Phone:203-200-4822
Mailing Address - Fax:203-200-2099
Practice Address - Street 1:333 CEDAR ST
Practice Address - Street 2:YALE UNIVERSITY SCHOOL OF MEDICINE
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510
Practice Address - Country:US
Practice Address - Phone:203-200-4822
Practice Address - Fax:203-200-2099
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2012-06-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT048823207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2037921Medicaid
MAJ27195OtherBCBS MA
MA469044OtherTUFTS HEALTH PLAN
MA2037921Medicaid
MAA36538Medicare ID - Type Unspecified