Provider Demographics
NPI:1174886469
Name:MICHAEL, AUSTIN JAMES (PA-C)
Entity type:Individual
Prefix:MR
First Name:AUSTIN
Middle Name:JAMES
Last Name:MICHAEL
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:DEPT 1210
Mailing Address - Street 2:PO BOX 4110
Mailing Address - City:WOBRUN
Mailing Address - State:MA
Mailing Address - Zip Code:01888-4110
Mailing Address - Country:US
Mailing Address - Phone:833-435-1112
Mailing Address - Fax:508-829-3814
Practice Address - Street 1:725 NORTH ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4109
Practice Address - Country:US
Practice Address - Phone:413-447-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA4429363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant