Provider Demographics
NPI:1750357679
Name:NEARY, MICHAEL T (DPM)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:T
Last Name:NEARY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:375 ALLENS AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-5010
Mailing Address - Country:US
Mailing Address - Phone:401-444-0400
Mailing Address - Fax:401-444-0468
Practice Address - Street 1:355 PRAIRIE AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-1928
Practice Address - Country:US
Practice Address - Phone:401-444-0570
Practice Address - Fax:401-415-9000
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIDPM00351213ES0103X
PASC-003638-L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery