Healthcare Provider Details

I. General information

NPI: 1437490307
Provider Name (Legal Business Name): MICHAEL A. PARENTEAU MD, JD, MPH, BS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MIKE PARENTEAU MD, JD, MPH, BS

II. Dates (important events)

Enumeration Date: 03/02/2013
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 MDG/RAF LAKENHEATH OPC 41 UNIT 5115
APO AE
09461-5115
US

IV. Provider business mailing address

48 MDG/RAF LAKENHEATH OPC 41 BOX 15
APO AE
09461-5115
US

V. Phone/Fax

Practice location:
  • Phone: 314-236-8737
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberMD-17772
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: