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NPI Code Detail

MEDICARE: DR. RICHARD MICHAUD DMD

MEDICARE:  DR. RICHARD  MICHAUD  DMD
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
11223E0200XEndodonticsDN17436FL

General Provider Information

NPI Number : 1497922777
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD MICHAUD DMD
Provider Business Mailing Address
First Line : 6323 CORPORATE CT
Second Line : SUITE A
City : FORT MYERS
State : FL
Zip : 33919-3518
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6323 CORPORATE CT
Second Line :
City : FORT MYERS
State : FL
Zip : 33919-3518
Country : US
Telephone Number : 239-482-5311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2008
Last Update Date : 05/12/2009

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Directions to “ DR. RICHARD MICHAUD DMD” Practice Location

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