Healthcare Provider Details

I. General information

NPI: 1144312422
Provider Name (Legal Business Name): MICHELLE A DUPLAIN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 LINCOLN WAY E
MASSILLON OH
44646-6950
US

IV. Provider business mailing address

1710 ALPHA ST NW
MASSILLON OH
44647-8655
US

V. Phone/Fax

Practice location:
  • Phone: 330-809-1800
  • Fax:
Mailing address:
  • Phone: 330-704-8909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1053333
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: