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NPI Code Detail

MEDICARE: DR. MICHAEL JOSEPH MARCHESSEAULT M.D.

MEDICARE: DR. MICHAEL JOSEPH MARCHESSEAULT M.D.
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
1207P00000XEmergency Medicine PhysicianG71949CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326063512
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL JOSEPH MARCHESSEAULT M.D.
Provider Business Mailing Address
First Line : 240 SPRUCE ST
Second Line :
City : GRIDLEY
State : CA
Zip : 95948-2216
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1065 BUCKS LAKE RD
Second Line :
City : QUINCY
State : CA
Zip : 95971-9599
Country : US
Telephone Number : 530-283-7161
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 02/18/2021

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