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NPI Code Detail

MEDICARE: MS. MICHELLE LOUISE CAMARATA MHA MDT PT

MEDICARE: MS. MICHELLE LOUISE CAMARATA MHA MDT PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist4225CT
2225100000XPhysical Therapist2305206791VA
3225100000XPhysical TherapistPT002364GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11255329934OTHERVANPI
25563079OTHERCTAETNA
3080004225CT07OTHERCTBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1255329934
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MICHELLE LOUISE CAMARATA MHA MDT PT
Provider Business Mailing Address
First Line : 1200 CORPORATE DR STE 400
Second Line :
City : HOOVER
State : AL
Zip : 35242-5424
Country : US
Telephone Number : 866-518-0283
Fax Number :
Provider Business Practice Location Address
First Line : 540 W CROSSVILLE RD STE 203
Second Line :
City : ROSWELL
State : GA
Zip : 30075-7524
Country : US
Telephone Number : 678-585-0175
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2005
Last Update Date : 06/10/2025

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