Provider Demographics
NPI:1528068517
Name:SAIDEL, MICHELLE SIMONE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:SIMONE
Last Name:SAIDEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MARY E CLARK DR
Mailing Address - Street 2:UNIT # 3
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NH
Mailing Address - Zip Code:03841-2288
Mailing Address - Country:US
Mailing Address - Phone:603-329-5694
Mailing Address - Fax:603-329-5197
Practice Address - Street 1:41820 GARSTIN DR.
Practice Address - Street 2:
Practice Address - City:BIG BEAR LAKE
Practice Address - State:CA
Practice Address - Zip Code:92315
Practice Address - Country:US
Practice Address - Phone:909-866-6501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-30
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10738174400000X
CA1600492084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No174400000XOther Service ProvidersSpecialist