Provider Demographics
NPI:1386606705
Name:MICHAUD, GREGORY FRANCIS (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:FRANCIS
Last Name:MICHAUD
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1701 BLAIR BLVD APT 2
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-5135
Mailing Address - Country:US
Mailing Address - Phone:615-663-7279
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-724-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA76723207RC0001X
TN55267207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAG25626Medicare UPIN