Provider Demographics
NPI:1831914928
Name:MICHEL, JAMES P
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:MICHEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 LAWRENCEVILLE SUWANEE RD STE A-670
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-2600
Mailing Address - Country:US
Mailing Address - Phone:707-355-6038
Mailing Address - Fax:973-378-0965
Practice Address - Street 1:2910 BUFORD DR APT 324
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-6520
Practice Address - Country:US
Practice Address - Phone:973-494-1407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver