MEDICARE: MICHELLE GIGOT PUENT MD

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	207Q00000X	Family Medicine Physician	39887	WI

General Provider Information

NPI Number	:	1982663118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE GIGOT PUENT MD

Provider Business Mailing Address
First Line	:	5807 WINDSONA CIR
Second Line	:
City	:	FITCHBURG
State	:	WI
Zip	:	53711-5854
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5807 WINDSONA CIR
Second Line	:
City	:	FITCHBURG
State	:	WI
Zip	:	53711-5854
Country	:	US
Telephone Number	:	608-358-8858
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	01/09/2017

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