Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Michael Andre Thibault Jr.

Individual provider Technician/Technologist · NPI 1023772209

Michael Andre Thibault Jr. is a Technician/Technologist in Dearborn, Michigan. Licensed in Michigan. Registered with an NPI since 2021.

Licensed in
MI
In the registry since
2021

Practice location Address checks out

19853 Outer Dr Ste 110
Dearborn, MI 48124-2044
Phone: (313) 406-5056
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Technician/Technologist (primary) Taxonomy 156F00000X (MI)

Record details

NPI number1023772209
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 25, 2021
Last updated in NPPESOctober 25, 2021
Certification dateOctober 25, 2021
Mailing address19853 Outer Dr Ste 110, Dearborn, MI 48124-2044

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