Provider Demographics
NPI:1881078970
Name:MOLITORIS, MICHAEL ANDREW (DPM)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANDREW
Last Name:MOLITORIS
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:1100 WESCOTT DR STE 303
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-4600
Mailing Address - Country:US
Mailing Address - Phone:908-788-6449
Mailing Address - Fax:908-788-6668
Practice Address - Street 1:1100 WESCOTT DR STE 303
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4600
Practice Address - Country:US
Practice Address - Phone:908-788-6449
Practice Address - Fax:908-788-6668
Is Sole Proprietor?:No
Enumeration Date:2015-07-17
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASC006688213ES0103X
NJ25MD00342700213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery