Provider Demographics
NPI:1366415275
Name:STAMM, MICHAEL A (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:STAMM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:510 NORTH ST STE 10
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4127
Mailing Address - Country:US
Mailing Address - Phone:413-448-8291
Mailing Address - Fax:413-447-9040
Practice Address - Street 1:510 NORTH ST STE 10
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201
Practice Address - Country:US
Practice Address - Phone:413-448-8291
Practice Address - Fax:413-447-9040
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH18281207Y00000X
VT042.0013772207Y00000X
MA205842207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP00131341OtherRAILROAD MEDICARE
MAJ22877OtherBCBSMA
MA000000028175OtherBMC
MA2595173OtherAETNA
MA198184006OtherCIGNA
MA0115860Medicaid
MA20-1056249OtherPLAN VISTA
MA20-1056249OtherPRIVATE HEALTHCARE SYSTEM
MA751325OtherCONNECTICARE
MA20-1056249OtherCONSOLIDATED
MA20-1056249OtherGREAT-WEST
MA205842OtherTUFTS
MA27477OtherHEALTH NEW ENGLAND
MA20-1056249OtherNORTHEAST HEALTH DIRECT
MAP00131341OtherRAILROAD MEDICARE
MA20-1056249OtherNORTHEAST HEALTHCARE ALLI
MA20-1056249OtherUNICARE/GIC
MAAA13700OtherHARVARD PILGRIM
MA20-1056249OtherNORTHEAST HEALTHCARE ALLI
MA205842OtherTUFTS