Provider Demographics
NPI:1730120569
Name:MICHAUD, VINCENT E (MD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:E
Last Name:MICHAUD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:33 WHITING HILL RD
Mailing Address - Street 2:SUITE300
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1021
Mailing Address - Country:US
Mailing Address - Phone:207-973-5035
Mailing Address - Fax:207-973-5042
Practice Address - Street 1:302 HUSSON AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3374
Practice Address - Country:US
Practice Address - Phone:207-941-2373
Practice Address - Fax:207-941-8803
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2014-02-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ME011511207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM0263Medicare ID - Type Unspecified
MEB86292Medicare UPIN