Individual
DR. MICHAEL P. GAUDET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 SOUTH ST, SOUTHBRIDGE, MA 01550-4051
(508) 765-9771
(508) 764-2448
Mailing address
100 SOUTH ST, SOUTHBRIDGE, MA 01550-4051
(508) 765-9771
(508) 764-2448
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
58733
MA
207R00000X
Internal Medicine Physician
058733
MA
207RI0200X
Infectious Disease Physician
058733
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3083471
—
MA
Enumeration date
04/20/2006
Last updated
11/03/2011
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