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General NPI Number Information
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NPI Number | 1609166339
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Entity Type | Individual
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Provider Name | MICHELLE MARIE MASTER MD
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Gender | Female
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Dates
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Enumeration Date | 04/14/2011
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 1400 CENTRE ST STE 206
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City | NEWTON
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State | MA
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Zip | 02459-2415
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Country | US
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Telephone | 617-795-0402
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Fax | 617-663-6049
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Provider Business Mailing Address
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Address Line | 1400 CENTRE ST STE 206
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City | NEWTON
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State | MA
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Zip | 02459-2415
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Country | US
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Telephone | 617-795-0402
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Fax | 617-663-6049
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 260287
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License Number State | MA
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