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NPI Code Detail

MEDICARE: DR. MICHELLE RENEE TRUMP O.D.

MEDICARE: DR. MICHELLE RENEE TRUMP 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
1152W00000XOptometrist789NH
2152W00000XOptometristOB009154PA
3152W00000XOptometrist0618000608VA
4152W00000XOptometristOEG001436PA

General Provider Information

NPI Number : 1881605962
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHELLE RENEE TRUMP O.D.
Provider Business Mailing Address
First Line : 750 MAPLE ST
Second Line : DR. MICHELLE R. TRUMP, PC
City : BLOOMSBURG
State : PA
Zip : 17815-2908
Country : US
Telephone Number : 603-630-3686
Fax Number : 570-329-0190
Provider Business Practice Location Address
First Line : 1015 NORTH LOYALSOCK AVE.
Second Line : VISION CENTER C/O DR. MICHELLE TRUMP
City : MONTOURSVILLE
State : PA
Zip : 17754-2283
Country : US
Telephone Number : 570-368-8820
Fax Number : 570-329-0190
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2006
Last Update Date : 01/29/2014

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