Michaela Smith
Physician Assistant in Boston, MA. Individual provider (NPI-1).
NPI number1013760131
StatusActive
Last updated in NPPESAug 15, 2024
Details
- NPI
- 1013760131
- Entity type
- Individual (NPI-1)
- Name
- Michaela Smith
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 9, 2024
- Certification date
- Aug 15, 2024
- Last updated
- Aug 15, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | – | – | Yes |
| 363A00000X | Physician Assistant | PA100881 | MA |
Practice location
179 Longwood AveBoston, MA 02115-5804
Phone 617-731-2918
Mailing address
179 Longwood AveBoston, MA 02115-5804
Phone 617-731-2918
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