Provider Demographics
NPI:1013020825
Name:GIROUX, MICHELLE S (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:S
Last Name:GIROUX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3455 HIGHWAY 153
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:SC
Mailing Address - Zip Code:29673-7725
Mailing Address - Country:US
Mailing Address - Phone:864-295-8811
Mailing Address - Fax:864-295-0806
Practice Address - Street 1:3455 HIGHWAY 153
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:SC
Practice Address - Zip Code:29673-7725
Practice Address - Country:US
Practice Address - Phone:864-295-8811
Practice Address - Fax:864-295-0806
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19530208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC562212236OtherCHAMPUS
SCGP2981Medicaid