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General NPI Number Information
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NPI Number | 1063953164
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Entity Type | Individual
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Provider Name | MICHAEL LEVASSEUR
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Gender | Male
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Dates
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Enumeration Date | 03/09/2017
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 88 WASHINGTON ST
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City | TAUNTON
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State | MA
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Zip | 02780-2465
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Country | US
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Telephone | 781-280-1695
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Fax | 781-276-6410
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Provider Business Mailing Address
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Address Line | PO BOX 417379
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City | BOSTON
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State | MA
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Zip | 02241-7379
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Country | US
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Telephone | 781-280-1695
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Fax | 781-276-6410
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 5059
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA6141
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License Number State | MA
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