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NPI Code Detail

MEDICARE: MICHELLE DESCHAMPLAIN MD

MEDICARE:   MICHELLE  DESCHAMPLAIN  MD
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
12086S0129XVascular Surgery Physician35C.002869OH
22086S0129XVascular Surgery Physician0101244277VA
32086S0129XVascular Surgery PhysicianME150243FL

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 : 1952510299
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE DESCHAMPLAIN MD
Provider Business Mailing Address
First Line : 714 MANATEE AVE E
Second Line :
City : BRADENTON
State : FL
Zip : 34208-1235
Country : US
Telephone Number : 941-212-2010
Fax Number : 941-212-3330
Provider Business Practice Location Address
First Line : 714 MANATEE AVE E
Second Line :
City : BRADENTON
State : FL
Zip : 34208-1235
Country : US
Telephone Number : 941-212-2010
Fax Number : 941-212-3330
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2007
Last Update Date : 06/04/2026

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