Provider Demographics
NPI:1457390692
Name:ARSENIAN, MICHAEL A (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:ARSENIAN
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 1:298 WASHINGTON ST.
Mailing Address - Street 2:LAHEY CARDIOLOGY, GLOUCESTER
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930
Mailing Address - Country:US
Mailing Address - Phone:978-282-3681
Mailing Address - Fax:978-381-7749
Practice Address - Street 1:298 WASHINGTON ST.
Practice Address - Street 2:LAHEY CARDIOLOGY, GLOUCESTER
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930
Practice Address - Country:US
Practice Address - Phone:978-282-3681
Practice Address - Fax:978-381-7749
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA49048207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3042448Medicaid
MA3042448Medicaid
J08136Medicare PIN