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NPI Code Detail

MEDICARE: OLIVIA PETE MICHAELS

MEDICARE:   OLIVIA PETE MICHAELS
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1396684395
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIA PETE MICHAELS
Provider Business Mailing Address
First Line : 2014 WASHINGTON ST
Second Line :
City : NEWTON
State : MA
Zip : 02462-1607
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2014 WASHINGTON ST
Second Line :
City : NEWTON
State : MA
Zip : 02462-1607
Country : US
Telephone Number : 617-243-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2026
Last Update Date : 03/25/2026

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Directions to “ OLIVIA PETE MICHAELS ” Practice Location

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