Provider Demographics
NPI:1013053982
Name:RHEAULT, MICHELLE NICOLE (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:NICOLE
Last Name:RHEAULT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:720 WASHINGTON AVE SE
Mailing Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414
Mailing Address - Country:US
Mailing Address - Phone:612-884-0649
Mailing Address - Fax:
Practice Address - Street 1:2512 S 7TH ST
Practice Address - Street 2:PEDIATRIC SPECIALTY CARE
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1404
Practice Address - Country:US
Practice Address - Phone:612-365-6777
Practice Address - Fax:612-624-1446
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2013-02-20
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Provider Licenses
StateLicense IDTaxonomies
NY2423532080P0210X
MN442502080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology