MEDICARE: DR. MICHAEL J VELSMID DPT

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	225100000X	Physical Therapist	10295	MA

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	:	1679554711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL J VELSMID DPT

Provider Business Mailing Address
First Line	:	PO BOX 322
Second Line	:
City	:	ALLSTON
State	:	MA
Zip	:	02134-0003
Country	:	US
Telephone Number	:	617-787-8700
Fax Number	:	617-242-7074

Provider Business Practice Location Address
First Line	:	1 BRAINTREE ST ST
Second Line	:
City	:	ALLSTON
State	:	MA
Zip	:	02134-1956
Country	:	US
Telephone Number	:	617-787-8700
Fax Number	:	617-787-8106

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

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	03/06/2015

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