Provider Demographics
NPI:1952340242
Name:ENGLAND, MICHAEL D (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:ENGLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1973 SLOAN PL
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55117-2094
Mailing Address - Country:US
Mailing Address - Phone:651-224-1347
Mailing Address - Fax:651-855-0126
Practice Address - Street 1:1973 SLOAN PL
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55117-2084
Practice Address - Country:US
Practice Address - Phone:651-224-1347
Practice Address - Fax:651-855-0126
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN30917174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN5T718ENOtherBLUE CROSS BLUE SHIELD
MN32189600OtherWISCONSIN MEDICAID
MN17-00301OtherMEDICA
MN32189600OtherWISCONSIN MEDICAID