Provider Demographics
NPI:1528558178
Name:TAO, MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:TAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:TAO
Other - Middle Name:
Other - Last Name:TAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:420 SAYBROOK RD STE A
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-4859
Mailing Address - Country:US
Mailing Address - Phone:860-636-2010
Mailing Address - Fax:
Practice Address - Street 1:420 SAYBROOK RD STE A
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-4772
Practice Address - Country:US
Practice Address - Phone:860-636-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-18
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT77677207RC0000X
NY321251207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease