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NPI Code Detail

MEDICARE: MICHELE M FROST

MEDICARE: MICHELE M FROST
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
1156FX1800XOptician4821-SC

General Provider Information

NPI Number : 1659078673
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE M FROST
Provider Business Mailing Address
First Line : 1761 MALCOLM RD
Second Line :
City : BUCYRUS
State : OH
Zip : 44820-9392
Country : US
Telephone Number : 419-544-7000
Fax Number :
Provider Business Practice Location Address
First Line : 555 COLEMANS XING
Second Line :
City : MARYSVILLE
State : OH
Zip : 43040-7042
Country : US
Telephone Number : 937-642-9495
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2023
Last Update Date : 02/09/2023

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