Edwige Michel

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10005472A Issued in IN

Practice address

1068 Merchants Dr Apt 424
Dallas, GA 30132-2969

Phone

(706) 784-3032

NPI assigned

Mar 31, 2025

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clinic Klinic

  • Primary Care Clinic/Center
  • Marietta, GA
  • NPI 1134793102
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1743379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1508669060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 POWDER SPRINGS RD SW STE 510",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300644849",
            "telephone_number": "770-875-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1068 MERCHANTS DR APT 424",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301322969",
            "telephone_number": "706-784-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHEL",
        "first_name": "EDWIGE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-31",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "TPPA812",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10005472A",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PR",
            "license": "2269",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alisha Mewborn
• Hailey Renee Meyers, LMSW
• Christine J. Mezza, LPC
• MH Dental Group, LLC
• Micgra Telehealth LLLP
• Joseph Baisden Mickler III, LPC
• Michael L Miles, MD
• Anna Miller, FNP-C
• Brian Keith Miller, PHARMD
• Mary Kea Miller, SLP

• Physician Assistant in Dallas, GA
• Providers in Dallas, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.