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NPI Code Detail

MEDICARE: DONNA S MICHELSON MD

MEDICARE: DONNA S MICHELSON MD
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
1207R00000XInternal Medicine Physician60683MA
2207RC0000XCardiovascular Disease Physician60683MA

Other Identifiers

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

General Provider Information

NPI Number : 1194712729
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONNA S MICHELSON MD
Provider Business Mailing Address
First Line : 246 TEMPLE ST
Second Line :
City : WEST NEWTON
State : MA
Zip : 02465-2334
Country : US
Telephone Number : 617-957-7837
Fax Number : 617-630-0929
Provider Business Practice Location Address
First Line : 10 LONGWOOD DR
Second Line : WELLNESS CENTER, FOX HILL VILLAGE
City : WESTWOOD
State : MA
Zip : 02090-1123
Country : US
Telephone Number : 781-493-6813
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2005
Last Update Date : 08/08/2014

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