Basic Information
| Provider Information | |||||||||
| NPI: | 1346212008 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALBERT | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 10417 | ||||||||
| Address2: | |||||||||
| City: | HOLYOKE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010412017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135400150 | ||||||||
| FaxNumber: | 4135400159 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 MEDICAL CENTER DR | ||||||||
| Address2: | SUITE # 404 | ||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011071270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137363163 | ||||||||
| FaxNumber: | 4137330206 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2006 | ||||||||
| LastUpdateDate: | 03/14/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 56073 | MA | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 733297 | 01 | MA | TUFTS | OTHER | J11029 | 01 | MA | BLUE CROSS BLUE SHIELD | OTHER | 1704384 | 01 | UNITED HEALTHCARE | OTHER | 10108 | 01 | MA | HEALTH NEW ENGLAND | OTHER | 484225 | 01 | CCARE | OTHER | 3078205 | 05 | MA | MEDICAID | 3502711-002 | 01 | MA | CIGNA | OTHER | 801563 | 01 | HARVARD PILGRIM | OTHER | 61710 | 01 | AETNA | OTHER | 6480 | 01 | MA | BMC HEALTHNET | OTHER |