Provider Demographics
NPI:1952543555
Name:GATHERIDGE, MICHELE ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:ANN
Last Name:GATHERIDGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-2412
Mailing Address - Fax:
Practice Address - Street 1:5818 N NEVADA AVE STE 225
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-3547
Practice Address - Country:US
Practice Address - Phone:719-365-3740
Practice Address - Fax:719-365-3741
Is Sole Proprietor?:No
Enumeration Date:2009-03-27
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CODR.00597642084N0008X, 2084N0400X
COCDRH.00597642084N0008X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine