MEDICARE: MICHELE L HATHERILL 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
1	207X00000X	Orthopaedic Surgery Physician	35055028	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	9338635	OTHER	OH	PARTNERS PHYSICIAN GROUP MEDICARE GROUP #

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1841239274	OTHER	OH	PARTNERS PHYSICIAN GROUP TYPE 2 NPI #

General Provider Information

NPI Number	:	1881672475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELE L HATHERILL MD

Provider Business Mailing Address
First Line	:	224 W EXCHANGE ST
Second Line	:	#440
City	:	AKRON
State	:	OH
Zip	:	44302-1704
Country	:	US
Telephone Number	:	330-344-1980
Fax Number	:	330-344-6038

Provider Business Practice Location Address
First Line	:	224 W EXCHANGE ST
Second Line	:	#440
City	:	AKRON
State	:	OH
Zip	:	44302-1704
Country	:	US
Telephone Number	:	330-344-1980
Fax Number	:	330-344-6038

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

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	02/26/2013

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Directions to “ MICHELE L HATHERILL MD” Practice Location

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