MEDICARE: MICHELLE DENIECE MCAFFEE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)		GA
2	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1134820723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE DENIECE MCAFFEE

Provider Business Mailing Address
First Line	:	5850 BEARING WAY
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30349-3564
Country	:	US
Telephone Number	:	813-520-6493
Fax Number	:

Provider Business Practice Location Address
First Line	:	5850 BEARING WAY
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30349-3564
Country	:	US
Telephone Number	:	813-520-6493
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2023
Last Update Date	:	03/13/2023

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