Provider Demographics
NPI:1215974803
Name:NADEAU, GERALD (DC)
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:
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:PO BOX 1747
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04241-1747
Mailing Address - Country:US
Mailing Address - Phone:207-782-2492
Mailing Address - Fax:
Practice Address - Street 1:336 CENTER ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-6153
Practice Address - Country:US
Practice Address - Phone:207-777-1104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR653111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME000691OtherBC/BS
ME0319OtherHARVARD PILGRAM
ME000691OtherBC/BS
MEMM0372Medicare PIN