Basic Information
Provider Information
NPI: 1427059005
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COCHRAN
FirstName: MICHELLE
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 20 RESEARCH PL
Address2: SUITE 320
City: NORTH CHELMSFORD
State: MA
PostalCode: 018632454
CountryCode: US
TelephoneNumber: 9782561858
FaxNumber: 9787887890
Practice Location
Address1: 20 RESEARCH PL
Address2: SUITE 320
City: NORTH CHELMSFORD
State: MA
PostalCode: 018632454
CountryCode: US
TelephoneNumber: 9782561858
FaxNumber: 9787887890
Other Information
ProviderEnumerationDate: 08/09/2005
LastUpdateDate: 02/20/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
174400000XH28005MAY Other Service ProvidersSpecialist 

ID Information
IDTypeStateIssuerDescription
002577501MANEIGHBORHOOD HEALTH PLANOTHER
142705900501MAHEALTH PLANS INCOTHER
20492601MAMEDICAL LICENSEOTHER
142705900501MABMC HEALTH NETOTHER
6509201MAFALLONOTHER
97869401MANETWORKOTHER
J2297601MABCBSOTHER
142705900501MACIGNAOTHER
142705900501MAHEALTH PARTNERSOTHER
012245905MA MEDICAID
142705900501MAGREAT WESTOTHER
20492601MATUFTSOTHER
142705900501MACHAMPUS/TRICAREOTHER
263692201MAATHENA/US HEALTHCAREOTHER
J2297601MAPREFERRED CARE NYOTHER
000539401MAMEDICARE RAILROADOTHER
142705900501MAPREFERRED CARE NYOTHER
AA11692901MAHPHCOTHER


Home