Provider Demographics
NPI:1366548042
Name:GINGRAS, MICHEL PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:MICHEL
Middle Name:PAUL
Last Name:GINGRAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2208 EXECUTIVE DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-6603
Mailing Address - Country:US
Mailing Address - Phone:757-826-7516
Mailing Address - Fax:757-826-6232
Practice Address - Street 1:2112 HARTFORD RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2409
Practice Address - Country:US
Practice Address - Phone:757-826-7516
Practice Address - Fax:757-826-6232
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010449952084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAO80069OtherSENTARA/OPTIMA
VA007105517Medicaid
VA320272OtherBLUE CROSS BLUE SHIELD