Provider Demographics
NPI:1255403473
Name:APIADO, MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:APIADO
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 1:7 VILLAGE GREEN DR
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06759-3433
Mailing Address - Country:US
Mailing Address - Phone:860-567-0130
Mailing Address - Fax:860-567-0125
Practice Address - Street 1:7 VILLAGE GREEN DR
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-3433
Practice Address - Country:US
Practice Address - Phone:860-567-0130
Practice Address - Fax:860-567-0125
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT038823207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004247872Medicaid
071834OtherMEDICARE
H16874Medicare UPIN
CT2303299Medicare ID - Type Unspecified