MEDICARE: ISABELLE M. AUDET MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician

General Provider Information

NPI Number	:	1902020837
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ISABELLE M. AUDET MD PC

Provider Business Mailing Address
First Line	:	809 W DRYDEN RD
Second Line	:
City	:	METAMORA
State	:	MI
Zip	:	48455-8961
Country	:	US
Telephone Number	:	810-678-8150
Fax Number	:	810-678-2972

Provider Business Practice Location Address
First Line	:	809 W DRYDEN RD
Second Line	:
City	:	METAMORA
State	:	MI
Zip	:	48455-8961
Country	:	US
Telephone Number	:	810-678-8150
Fax Number	:	810-678-2972

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ISABELLE M AUDET
Credential	:	M.D.
Telephone Number	:	810-678-8150

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	10/03/2007

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