Provider Demographics
NPI:1558441105
Name:COVIELLO, MICHELE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:
Last Name:COVIELLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1177 BOSTON PROVIDENCE TPKE
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-5019
Mailing Address - Country:US
Mailing Address - Phone:781-278-5540
Mailing Address - Fax:781-762-7623
Practice Address - Street 1:1177 BOSTON PROVIDENCE TPKE
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-5019
Practice Address - Country:US
Practice Address - Phone:781-278-5540
Practice Address - Fax:781-762-7623
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA151127207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
3164594Medicare PIN
MA3164594Medicare ID - Type Unspecified
MAG43625Medicare UPIN
G43625Medicare UPIN