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General NPI Number Information
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NPI Number | 1669112934
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Entity Type | Individual
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Provider Name | MICHELLE GIFFORD
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Gender | Female
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Dates
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Enumeration Date | 04/01/2022
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 246 GRANGER RD STE 2
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City | BARRE
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State | VT
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Zip | 05641-5352
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Country | US
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Telephone | 802-225-5819
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Fax |
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Provider Business Mailing Address
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Address Line | MAINE MEDICAL CENTER 22 BRAMHALL STREET
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City | PORTLAND
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State | ME
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Zip | 04102
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | EC221008
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 042.0018576
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License Number State | VT
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