Vincent E Michaud, M.D.
Individual provider Active NPI Family Medicine Physician · Bangor, ME
NPI 1730120569 · NPPES record last updated Feb 26, 2014
Key facts
- NPI
- 1730120569
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 011511 (ME)
- Practice address
- 302 Husson Ave
Suite 2
Bangor, ME 04401-3374 - Phone
- (207) 941-2373
- Fax
- (207) 941-8803
- NPI assigned
- Jun 10, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040302000956 | ME | Practitioner - Family Practice | 5395632566 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011511 | ME | MD | Family Medicine Physician |
| 1154 | ME | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastern Maine Medical Center | Current |
Accepting new patients | |
| Eastern Maine Medical Center | Current |
Accepting new patients |
Locations
302 Husson Ave
Ste 2
Bangor, ME 04401
Phone (207) 941-2373
302 Husson Ave
Bangor, ME 04401
Phone (207) 941-2373
489 State St
Bangor, ME 04401
Phone (207) 973-8837
931 Union St
Fl 3
Bangor, ME 04401
33 Whiting Hill Rd
Ste 300
Brewer, ME 04412
Phone (207) 973-7478
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 011511 | ME | Yes |
Addresses
Primary practice location
302 Husson Ave
Suite 2
Bangor, ME 04401-3374
Mailing address
33 Whiting Hill Rd
Suite300
Brewer, ME 04412-1021
Phone (207) 973-5035
Other providers in Bangor, ME
- Maria Michailidou
- Mark Philip Michalowski
- Justin Michaud
- Lindsay Michaud
- Marilyn L Michaud
- Michele E. Spekhardt, DMD. P.a.
- Ryan Middleton
- Midlands Neurobehavioral Services, LLC
- Ayman Mijalli
- Catherine Rose Mikowski
All providers in Bangor, ME · Family Medicine Physician in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.