Healthcare Provider Details

I. General information

NPI: 1073498267
Provider Name (Legal Business Name): MICHELLE D'INDIA RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 NOYES CT APT 1
AUGUSTA ME
04330-4746
US

IV. Provider business mailing address

1 NOYES CT APT 1
AUGUSTA ME
04330-4746
US

V. Phone/Fax

Practice location:
  • Phone: 978-758-0497
  • Fax:
Mailing address:
  • Phone: 978-758-0497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: