Keith Michl MD Facp
Organization Active NPI Specialist · Manchester Ctr, VT
NPI 1114180494 · NPPES record last updated Jul 7, 2008
Key facts
- NPI
- 1114180494
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- 0420007111 (VT)
- Legal business name
- KEITH MICHL MD FACP
- Practice address
- 7252 Main Street
Manchester Ctr, VT 05255 - Phone
- (802) 362-9031
- Fax
- (802) 362-7562
- NPI assigned
- Jul 7, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Keith W Michl, MD
- Title
- Internal Medicine
- Phone
- (802) 362-9031
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 47D0951326 | Keith Michl MD | Certificate of waiver | May 5, 2027 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 0420007111 | VT | Yes |
Addresses
Primary practice location
7252 Main Street
Manchester Ctr, VT 05255
Mailing address
7252 Main Street
PO Box 1431
Manchester Center, VT 05255
Phone (802) 362-9031
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0006032 | Medicaid | VT |
Other providers in Manchester Ctr, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.