DR. MICHAEL DEAN MEDLOCK (NPI# 1902887185) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902887185 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL DEAN MEDLOCK |
| Credential | MD |
| Practice Address |
47 Congress St Salem MA 01970 |
| Mailing Address |
27 Congress St Ste 513 Salem MA 01970-5523 |
| Practice Telephone | 9787448388 |
| Mailing Telephone | 9787448388 |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2019-04-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | 79690 | MA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 79690 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 11000546A | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4 Centennial Dr, North Shore Neurosurgery and Spine, Peabody, MA 019607935 | 9789770586 | 9789770905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235495623 | Michael Brodie Medlock | Chiropractor | 1300 Iroquois Ave, Suite 270, Naperville, IL 60563-8553 | 2012-04-10 |
| Street Address |
47 CONGRESS ST |
| City | SALEM |
| State | MA |
| Zip Code | 01970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790771756 | Kiame Jackson Mahaniah | Family Medicine | 47 Congress St, Salem, MA 01970-7308 | 2005-09-26 |
| 1043836513 | Sasha Pierina Grullon | Nurse Practitioner | 47 Congress St, Salem, MA 01970-7308 | 2020-06-22 |
| 1780230094 | Kianna Altagracia Contreras | Nurse Practitioner | 47 Congress St, Salem, MA 01970-7308 | 2019-08-13 |
| 1801449863 | Massiel Reyes | Nurse Practitioner | 47 Congress St, Salem, MA 01970-7308 | 2019-07-18 |
| 1386134807 | Courtney Mcdonald | Nurse Practitioner | 47 Congress St, Salem, MA 01970 | 2018-05-10 |
| 1720599145 | Eileen Quijada | Dentist | 47 Congress St, Salem, MA 01970 | 2017-10-12 |
| 1679008783 | Peguy Sylvain | Nurse Practitioner | 47 Congress St, Salem, MA 01970 | 2017-04-26 |
| 1609312404 | Jennifer Burns | Counselor | 47 Congress St, Salem, MA 01970-7308 | 2017-01-17 |
| 1326495151 | Kara Pesola | Nurse Practitioner | 47 Congress St, Salem, MA 01970-7308 | 2016-05-23 |
| 1386098960 | Heather Delisi | Nurse Practitioner | 47 Congress St, Suite 504, Salem, MA 01970-7308 | 2016-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053939108 | Sara Jane Garofalo | Social Worker | Bil-behavioral Health Esp, 35 Congress Street, Salem, MA 01970 | 2020-07-06 |
| 1326660267 | Leslie Marie Adams | Counselor | 35 Congress St #214, Salem, MA 01970 | 2020-05-14 |
| 1801435870 | Sarah Katherine Bolte | Counselor | 35 Congress St., Bldg. 2 Suite 351a, Salem, MA 01970 | 2019-12-23 |
| 1548814866 | Amy Carlson-pallazola | Counselor | 35 Congress Street Building 2, Suite 351a, Salem, MA 01970 | 2019-07-25 |
| 1932768850 | Alaina Kinsella | Counselor | 70 Boston Street, Unit 109, Salem, MA 01970 | 2019-06-13 |
| 1104384569 | Erica Jean Last | Community Health Worker | 35 Congress Street, Building 2, Suite 150c, Salem, MA 01970 | 2019-03-05 |
| 1467928184 | Jean David Thomas | Nurse Practitioner | Salem Family Health Center, 47 Congress Street, Salem, MA 01970 | 2018-10-20 |
| 1669950267 | Marla P. Meyer | Social Worker | 39 Norman Street, Third Floor, Salem, MA 01970 | 2018-08-06 |
| 1831689009 | Elisa M Castillo | Psychologist | 352 Lafayette Street, Salem, MA 01970 | 2018-05-14 |
| 1073003513 | Ryan Daniel Robichaud-fuentes | Counselor | 1 Salem Green Suite 103, Salem, MA 01970 | 2018-05-10 |
| Find all providers in zip 01970 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760718456 | John D. White | Neurological Surgery | 3582 El Dorado Loop S, Salem, OR 97302-9723 | 2009-10-30 |
| 1134272743 | Claudia Hildegard Martin | Neurological Surgery | 1900 Electric Rd Ste 1050, Salem, VA 24153-7474 | 2007-01-18 |
| 1295748218 | James A Saadi | Neurological Surgery | 1802 Braeburn Drive, Salem, VA 24153 | 2006-08-14 |
| 1205817418 | Robert C Buza | Neurological Surgery | 875 Oak St Se Ste 5085, Salem, OR 97301-3923 | 2005-11-07 |
| 1952307498 | Jerry Leroy Hubbard | Neurological Surgery | 875 Oak St Se, Ste 5060, Salem, OR 97301-3987 | 2005-06-21 |
| 1811500671 | Pride Neuroscience Group LLC | Neurological Surgery | 2480 Liberty St Ne Ste 180, Salem, OR 97301-8388 | 2020-08-30 |
| 1902378946 | Capital Neurosurgery Specialists | Neurological Surgery | 875 Oak St Se Ste 5060, Salem, OR 97301-3987 | 2018-12-31 |
| 1588140263 | Capital Neurosurgery Specialists | Neurological Surgery | 875 Oak St Se Ste 5060, Salem, OR 97301-3987 | 2018-07-16 |
| 1326492273 | Harron Neurosurgery, PC | Neurological Surgery | 150 Spartan Dr, Salem, VA 24153-3208 | 2016-04-18 |
| 1841693363 | Charles V. Hatchette II, Md, LLC | Neurological Surgery | 875 Oak St Se, Suite 5060, Salem, OR 97301-3975 | 2014-09-29 |
| Find all providers in SALEM | ||||
Please comment or provide details below to improve the information on DR. MICHAEL DEAN MEDLOCK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.