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General NPI Number Information
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NPI Number | 1609821073
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Entity Type | Individual
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Provider Name | MICHELLE M. MAUREAU DO
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Gender | Female
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 17717 MASONIC
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City | FRASER
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State | MI
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Zip | 48026-3158
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Country | US
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Telephone | 586-294-0600
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Fax |
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Provider Business Mailing Address
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Address Line | 17717 MASONIC
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City | FRASER
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State | MI
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Zip | 48026-3158
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Country | US
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Telephone | 586-294-0600
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 79108
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 226301
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 5101012819
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 5101012819
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License Number State | MI
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