| Type | Legal entity | [sources] | |||
|---|---|---|---|---|---|
| Name | Couillard, Michael B. · MICHAEL BENJAMIN COUILLARD | [sources] | |||
| Legal form | not available | [sources] | |||
| Country | United States | [sources] | |||
| NPI | 1386692499 | [sources] | |||
| Sector | Ind-Lic HC Serv Prov - Nurse Anesthetist | [sources] | |||
| Status | not available | [sources] | |||
| Address | CHARLOTTE, NC 28204 · Charlotte, NC 28204 | [sources] | |||
| Last change | Last processed | First seen | |||
Service providers who have been terminated for cause from North Carolina's Medicaid and other Health Programs.
United States · NC Medicaid Division of Health Benefits
Medical providers excluded from South Carolina's Medicaid program.
United States · SCDHHS
us-mednc-609cb326ede05c12d8e7408ed866ea17d810ea0d · us-medsc-ecdfbe49682e720485febf296e21c4a3d6e0c535For experts: raw data explorer
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| United States | South Carolina Department of Health and Human Services | - | - |