Healthcare Provider Details

I. General information

NPI: 1174804256
Provider Name (Legal Business Name): MICHELLE R. ACHOR DPM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2011
Last Update Date: 12/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 S STANFIELD RD
TROY OH
45373-2992
US

IV. Provider business mailing address

47 S STANFIELD RD
TROY OH
45373-2992
US

V. Phone/Fax

Practice location:
  • Phone: 937-339-4330
  • Fax: 937-335-5234
Mailing address:
  • Phone: 937-339-4330
  • Fax: 937-335-5234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number36.003487
License Number StateOH

VIII. Authorized Official

Name: DR. MICHELLE R ACHOR
Title or Position: PODIATRIST
Credential: DPM
Phone: 937-339-4330