Provider Demographics
NPI:1538158464
Name:MICHAUD, STEPHEN J (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:J
Last Name:MICHAUD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:17A TATRO RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GOFFSTOWN
Mailing Address - State:NH
Mailing Address - Zip Code:03045-2370
Mailing Address - Country:US
Mailing Address - Phone:603-314-4500
Mailing Address - Fax:603-314-4504
Practice Address - Street 1:17A TATRO RD
Practice Address - Street 2:SUITE 201
Practice Address - City:GOFFSTOWN
Practice Address - State:NH
Practice Address - Zip Code:03045-2370
Practice Address - Country:US
Practice Address - Phone:603-314-4500
Practice Address - Fax:603-314-4504
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2012-07-02
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Provider Licenses
StateLicense IDTaxonomies
NH11384207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH101115804OtherW/C - DEPT OF LABOR
NH01YP03536NH01OtherANTHEM ACES #
NH01-02434OtherUHC
NH437851OtherCIGNA
NHNH2273OtherHPHC
NH2673303OtherAETNA
NH080178216OtherRR MEDICARE
NH30201764Medicaid
NH011384OtherTUFTS
NHH50988OtherUPIN FOR ANTHEM REFERRALS
NHH50988OtherUPIN FOR ANTHEM REFERRALS
NH01-02434OtherUHC