MEDICARE: MS. MICHELLE SUZANNE DUQUET

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
1	247200000X	Other Technician	D230603778544	MI

General Provider Information

NPI Number	:	1649659905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELLE SUZANNE DUQUET

Provider Business Mailing Address
First Line	:	9456 LAKE CREST DR.
Second Line	:
City	:	WHITMORE LAKE
State	:	MI
Zip	:	48189
Country	:	US
Telephone Number	:	810-599-4561
Fax Number	:

Provider Business Practice Location Address
First Line	:	9456 LAKE CREST DR
Second Line	:
City	:	WHITMORE LAKE
State	:	MI
Zip	:	48189-9388
Country	:	US
Telephone Number	:	810-599-4561
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2015
Last Update Date	:	05/20/2015

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