Individual
MICHELLE VIDAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3 WASHINGTON ST STE 200, NORTH EASTON, MA 02356-1034
(617) 480-3188
Mailing address
23 PINE ST UNIT D, CANTON, MA 02021-3346
(617) 480-3188
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA7369
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/18/2019
Last updated
07/30/2025
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