DR. MICHAEL DAVID GAUTREAUX (NPI# 1427129279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427129279 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL DAVID GAUTREAUX |
| Credential | PH.D. |
| Practice Address |
145 Kimel Park Dr Suite 250 Winston Salem NC 27103-6984 |
| Practice Telephone | 3367164456 |
| Practice Fax Number | 3367747665 |
| Mailing Telephone | 3367164456 |
| Mailing Fax Number | 3367747665 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 170100000X | Medical Genetics, Ph.D. Medical Genetics | Other Service Providers |
| Street Address |
145 KIMEL PARK DR SUITE 250 |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-6984 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447775119 | Emily Moon | Nurse Anesthetist, Certified Registered | 145 Kimel Park Dr, Suite 120, Winston Salem, NC 27103 | 2017-08-03 |
| 1972039329 | Matthew Bryant Foster | Nurse Anesthetist, Certified Registered | 145 Kimel Park Dr, Suite 120, Winston Salem, NC 27103-6984 | 2017-05-04 |
| 1790228278 | Emily Stone | Nurse Anesthetist, Certified Registered | 145 Kimel Park Dr, Suite 120, Winston Salem, NC 27103-6984 | 2016-12-01 |
| 1437603891 | Evan Blake Moon | Nurse Anesthetist, Certified Registered | 145 Kimel Park Dr, Suite 120, Winston Salem, NC 27103-6984 | 2016-08-15 |
| 1407309677 | Patrick James Parcell | Nurse Anesthetist, Certified Registered | 145 Kimel Park Dr, Suite 120, Winston Salem, NC 27103-6984 | 2016-07-25 |
| 1518410786 | Jessica Lloyd Rothrock | Nurse Anesthetist, Certified Registered | 145 Kimel Park Dr, Suite 120, Winston Salem, NC 27103-6984 | 2016-07-25 |
| 1063965234 | Benjamin Joseph Boehnlein | Nurse Anesthetist, Certified Registered | 145 Kimel Park Dr, Suite 120, Winston Salem, NC 27103-6984 | 2016-07-25 |
| 1891171682 | Nicholas Dane Pulliam | Nurse Anesthetist, Certified Registered | 145 Kimel Park Dr, Suite 120, Winston Salem, NC 27103-6984 | 2015-08-04 |
| 1790161818 | Deborah Reece | Physician Assistant | 145 Kimel Park Dr, Suite 330, Winston Salem, NC 27103-6984 | 2015-07-31 |
| 1720466840 | Kristen Marisa Bettis | Nurse Anesthetist, Certified Registered | 145 Kimel Park Dr, Suite 120, Winston Salem, NC 27103-6984 | 2015-05-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
| 1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
| 1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
| 1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
| 1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
| 1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
| 1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
| 1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
| Find all providers in zip 27103 | ||||
| Taxonomy Code | 170100000X |
| Grouping | Other Service Providers |
| Classification | Medical Genetics, Ph.D. Medical Genetics |
| A medical geneticist works in association with a medical specialist, is affiliated with a clinical genetics program, and serves as a consultant to medical and dental specialists. |
| Notes: A general certificate was first issued by ABMS in 1982. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881799823 | Hiba Risheg | Medical Genetics, Ph.D. Medical Genetics | 201 Sage Rd Ste 300, Chapel Hill, NC 27514-6510 | 2006-09-14 |
| 1215044813 | Joe Mcknitt Alexander Jr. | Medical Genetics, Ph.D. Medical Genetics | 2911 Breezewood Ave Ste 201, Fayetteville, NC 28303 | 2006-08-23 |
| 1285740142 | Powells Medical Facility | Medical Genetics, Ph.D. Medical Genetics | 201 W Clinton St, Roseboro, NC 28382 | 2006-08-22 |
| 1013945732 | Siby Sebastian | Medical Genetics, Ph.D. Medical Genetics | 4425 Ben Franklin Blvd, Durham, NC 27704-2147 | 2006-06-29 |
| 1487622452 | Jack Tarleton | Medical Genetics, Ph.D. Medical Genetics | 267 Mcdowell St, Fullerton Genetics Laboratory, Asheville, NC 28803-2606 | 2006-03-08 |
| 1104890615 | Twanna Belinda Dixon-cherry | Medical Genetics, Ph.D. Medical Genetics | 118 W Martin Luther King Jr Dr, Washington, NC 27889-4906 | 2006-02-14 |
| 1578533360 | Megan M Harlan | Medical Genetics, Ph.D. Medical Genetics | 103 Mason Farm Road, Mbrb, Suite 4200, Campus Box 7264, Chapel Hill, NC 27599-0001 | 2006-01-24 |
| 1275510695 | Rapha Health System Inc | Medical Genetics, Ph.D. Medical Genetics | 1905 Skibo Rd, Suite 100, Fayetteville, NC 28314-1518 | 2005-12-28 |
| 1831194976 | Moon S Choi - Chung | Medical Genetics, Ph.D. Medical Genetics | 74 Eastgate Dr, Sylva, NC 28779-5171 | 2005-06-16 |
| 1811991342 | Myra Jane Hall | Medical Genetics, Ph.D. Medical Genetics | 210 Magnolia Square Court, Aberdeen, NC 28315-2226 | 2005-06-13 |
| Find all providers with the same taxonomy | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.