Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | DO02711 | ME |
N | 207R00000X | Internist | DO2711 | ME |
N | 111NI0900X | Internist | DO2711 | ME |
NPI | 1073878468 |
---|---|
Provider Name | Dr. Chelsea Michaud |
First Address | Portland, ME 04102-2788 |
Second Address | Portland, ME 04102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2012 |
Last Update Date | 11/08/2018 |