Individual
TODD M. MICHAELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 FODEN ROAD, EAST, SUITE 203, SOUTH PORTLAND, ME 04106
(207) 874-1489
(207) 523-8590
Mailing address
100 GANNETT DR STE C, SOUTH PORTLAND, ME 04106-5900
(207) 347-2947
(207) 874-2317
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD20112
ME
Other
Enumeration date
06/17/2011
Last updated
03/03/2026
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