Basic Information
| Provider Information | |||||||||
| NPI: | 1669453981 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NORTH | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | UKLEJA | ||||||||
| OtherFirstName: | MICHELLE | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 75 WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020611795 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7817924191 | ||||||||
| FaxNumber: | 7818786750 | ||||||||
| Practice Location | |||||||||
| Address1: | 51 PERFORMANCE DR | ||||||||
| Address2: | |||||||||
| City: | WEYMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021893104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7816828000 | ||||||||
| FaxNumber: | 7813351412 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/14/2005 | ||||||||
| LastUpdateDate: | 06/25/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 216984 | MA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 042297845 | 01 | MA | TRICARE | OTHER | 042297845 | 01 | MA | GREAT WEST HEALTH CARE | OTHER | 216984 | 01 | MA | TUFTS MEDICARE PREFERRED | OTHER | J26212 | 01 | MA | BCBS | OTHER | 80769 | 01 | MA | FALLON | OTHER | 042297845 | 01 | MA | HCVM | OTHER | 042297845 | 01 | MA | UNITED HEALTH CARE | OTHER | 2010992 | 05 | MA | MEDICAID | 6521164 | 01 | MA | CIGNA | OTHER | 7852455 | 01 | MA | AETNA | OTHER | AA11867 | 01 | MA | HVD PILGRIM HEALTH CARE | OTHER | 0032152 | 01 | MA | NEIGHBORHOOD HLTH PLAN | OTHER | 216984 | 01 | MA | TUFTS | OTHER | 042297845 | 01 | MA | GIC UNICARE | OTHER | 042297845 | 01 | MA | PRIVATE HEALTHCARE SYSTEM | OTHER |