Individual ProviderMichael Edward GreenChiropractorChiropractic ProvidersPractice Address133 Sylvan St, Danvers, MA 01923(978) 777-0918PECOS EnrollmentBased on the most recent information from CMS, provider Michael Edward Green does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 10:04 AM.Profile DetailsProvider ID1609861889Provider TypeIndividualFull NameGreen, Michael EdwardTitleDr.CredentialDCGenderMaleSole ProprietorYesEnumeration Date9/14/2005Last Updated6/30/2010Contact InformationPractice LocationPractice Address133 Sylvan St, Danvers, MA 01923Phone(978) 777-0918Fax(978) 774-7521Mailing LocationMailing Address133 Sylvan St, Danvers, MA 01923Phone(978) 777-0918Fax(978) 774-7521Provider TaxonomiesCodeDescriptionLicenseCode111N00000XPrimaryDescriptionChiropractorChiropractic ProvidersLicense451MassachusettsCode111N00000XDescriptionChiropractorChiropractic ProvidersLicense482MaineProvider IdentifiersIDDescriptionIssuerIDY35285DescriptionOtherIssuerBC BSMassachusettsID304584DescriptionOtherIssuerTUFTSMassachusettsIDY35285DescriptionMedicaidIssuerUnlistedMassachusetts