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NPI Code Detail

MEDICARE: DR. MICHELLE LYNN WERTELET O.D.

MEDICARE:  DR. MICHELLE LYNN WERTELET  O.D.
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
1152W00000XOptometristOEG001764PA

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 : 1477577369
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHELLE LYNN WERTELET O.D.
Provider Business Mailing Address
First Line : 1005 BEAVER GRADE RD STE G10
Second Line :
City : MOON TOWNSHIP
State : PA
Zip : 15108-2964
Country : US
Telephone Number : 412-308-9111
Fax Number : 412-308-9112
Provider Business Practice Location Address
First Line : 1005 BEAVER GRADE RD STE G10
Second Line :
City : MOON TOWNSHIP
State : PA
Zip : 15108-2964
Country : US
Telephone Number : 412-308-9111
Fax Number : 412-308-9112
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 06/13/2022

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Directions to “ DR. MICHELLE LYNN WERTELET O.D.” Practice Location

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