Provider Demographics
NPI:1700879517
Name:BRALOWER, MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:BRALOWER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-2103
Mailing Address - Country:US
Mailing Address - Phone:978-746-7867
Mailing Address - Fax:978-746-7867
Practice Address - Street 1:10 GEORGE ST
Practice Address - Street 2:SUITE 300
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-2293
Practice Address - Country:US
Practice Address - Phone:978-458-1463
Practice Address - Fax:978-454-3051
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA360482084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAC05069OtherBCBSMA
MA2044242Medicaid
MA23558OtherFCHP
MA700569OtherTHP
MA4475131OtherAETNA
NH0102752Y0MA01OtherANTHEM
MA0344470001OtherCIGNA
MA11728OtherHPHC
NH00000018Medicaid
MA0003746OtherNHP
NH00000018Medicaid
MA23558OtherFCHP
MA4475131OtherAETNA