Individual
DR. MICHELE A PREVOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3000 32ND AVE S, FARGO, ND 58103-6132
(701) 364-8000
Mailing address
607 S 24TH AVE, PMB384, WAUSAU, WI 54401
(715) 216-7795
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
61797-20
WI
Other
Enumeration date
10/28/2005
Last updated
07/21/2022
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