Provider Demographics
NPI:1669598561
Name:CIRILLI, MICHAEL JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:CIRILLI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:BOX 5967
Mailing Address - Street 2:DRS LENOIR & CIRILLI PA
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38704-5967
Mailing Address - Country:US
Mailing Address - Phone:662-335-3541
Mailing Address - Fax:662-332-0331
Practice Address - Street 1:1307 E UNION
Practice Address - Street 2:DOCTORS LENOIR & CIRILLI PA
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38703
Practice Address - Country:US
Practice Address - Phone:662-335-3541
Practice Address - Fax:662-332-0331
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MS10254207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0015848Medicaid
B30498Medicare UPIN