Provider Demographics
NPI:1013988559
Name:LEMIEUX, MICHAEL C (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:C
Last Name:LEMIEUX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 EVERGREEN DR
Mailing Address - Street 2:CENTRAL MAINE HEART & VASCULAR
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04963
Mailing Address - Country:US
Mailing Address - Phone:207-861-5774
Mailing Address - Fax:207-861-5990
Practice Address - Street 1:11 EVERGREEN DR
Practice Address - Street 2:CENTRAL MAINE HEART & VASCULAR
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04963
Practice Address - Country:US
Practice Address - Phone:207-861-5774
Practice Address - Fax:207-861-5990
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME012277207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME106880099Medicaid
MEMM755601Medicare PIN
MEMM7556Medicare ID - Type Unspecified
MED03610Medicare UPIN