NPI 1083078539

Michael Edmond Theriault, MD

Practitioner Neurology Physician Paoli, PA

Practice location

Address: 21 Industrial Blvd, Paoli, PA 19301-1610
Phone: (610) 647-8000

Registered specialties

Neurology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2084N0400X Licence MD473446 (PA)

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Registry record

NPI: 1083078539
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Apr 2016
Record last updated: 3 Nov 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.