MEDICARE: MICHELLE R. ACHOR DPM LLC

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	213E00000X	Podiatrist	36.003487	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174804256
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHELLE R. ACHOR DPM LLC

Provider Business Mailing Address
First Line	:	47 S STANFIELD RD
Second Line	:
City	:	TROY
State	:	OH
Zip	:	45373-2992
Country	:	US
Telephone Number	:	937-339-4330
Fax Number	:	937-335-5234

Provider Business Practice Location Address
First Line	:	47 S STANFIELD RD
Second Line	:
City	:	TROY
State	:	OH
Zip	:	45373-2992
Country	:	US
Telephone Number	:	937-339-4330
Fax Number	:	937-335-5234

Authorized Official
Title or Position	:	PODIATRIST
Name	:	DR. MICHELLE R ACHOR
Credential	:	DPM
Telephone Number	:	937-339-4330

Provider Enumeration Date	:	09/02/2011
Last Update Date	:	12/28/2011

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