Provider Demographics
NPI:1124244702
Name:NADEAU, RICHARD M (DC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:M
Last Name:NADEAU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-3951
Mailing Address - Country:US
Mailing Address - Phone:207-344-6488
Mailing Address - Fax:207-344-6490
Practice Address - Street 1:475 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-3951
Practice Address - Country:US
Practice Address - Phone:207-344-6488
Practice Address - Fax:207-344-6490
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1457111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor