Provider Demographics
NPI:1427129279
Name:GAUTREAUX, MICHAEL DAVID (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DAVID
Last Name:GAUTREAUX
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Gender:M
Credentials:PHD
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Mailing Address - Street 1:145 KIMEL PARK DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6984
Mailing Address - Country:US
Mailing Address - Phone:336-716-4456
Mailing Address - Fax:336-774-7665
Practice Address - Street 1:145 KIMEL PARK DR
Practice Address - Street 2:SUITE 250
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-6984
Practice Address - Country:US
Practice Address - Phone:336-716-4456
Practice Address - Fax:336-774-7665
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics