Healthcare Provider Details

I. General information

NPI: 1356004253
Provider Name (Legal Business Name): MICHAL CLAYTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2021
Last Update Date: 02/26/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 MILL ST
BELMONT MA
02478-1048
US

IV. Provider business mailing address

115 MILL STREET MAILSTOP 113
BELMONT MA
02478-1048
US

V. Phone/Fax

Practice location:
  • Phone: 617-855-2000
  • Fax:
Mailing address:
  • Phone: 617-855-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: