Provider Demographics
NPI:1851303655
Name:BEAUPRE, MICHELLE J (MD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:J
Last Name:BEAUPRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:362 BEDFORD STREET
Mailing Address - Street 2:
Mailing Address - City:EAST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02333-1465
Mailing Address - Country:US
Mailing Address - Phone:508-350-2350
Mailing Address - Fax:508-350-2318
Practice Address - Street 1:1 COMPASS WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:EAST BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02333-1465
Practice Address - Country:US
Practice Address - Phone:508-350-2300
Practice Address - Fax:508-350-2307
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA216381207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA714257OtherHPHC
MAA3514801OtherMEDICARE PTAN
MAJ25977OtherMABC
MA216381OtherTUFTS
0103384OtherUHC
MA6102254001OtherCIGNA
MA2005808Medicaid
MA6102254001OtherCIGNA
MAA35148Medicare PIN