Provider Demographics
NPI:1073878468
Name:MICHAUD, CHELSEA (DO)
Entity Type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:
Last Name:MICHAUD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 FORE RIVER PKWY
Mailing Address - Street 2:STE 410
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-2788
Mailing Address - Country:US
Mailing Address - Phone:207-774-9839
Mailing Address - Fax:207-761-2127
Practice Address - Street 1:195 FORE RIVER PKWY STE 410
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102
Practice Address - Country:US
Practice Address - Phone:207-774-9839
Practice Address - Fax:207-761-2127
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2018-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDO2711207R00000X
MEDO02711207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine