Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 12269 | NH |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 31401 | AZ |
NPI | 1063491702 |
---|---|
Provider Name | Marc J Michaud |
First Address | Nashua, NH 03062-1304 |
Second Address | Manchester, NH 03103-2734 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2006 |
Last Update Date | 11/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30204355 | (05) | NH |
H89744 | (02) | NH |