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

Michael Edmond Theriault, MD

Individual provider Neurology Physician · NPI 1083078539

Michael Edmond Theriault, MD is a Neurology in Paoli, Pennsylvania. Graduated from New York Medical College in 2016, 10 years ago. Practices with Phoenix Rehabilitation and Health Services Inc, a 2,720-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Pennsylvania.

Years since qualifying
10
Trained at
New York Medical College
Licensed in
PA
In the registry since
2016
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

21 Industrial Blvd
Paoli, PA 19301-1610
Phone: (610) 647-8000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X · Licence MD473446 (PA)

Record details

NPI number1083078539
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 11, 2016
Last updated in NPPESNovember 3, 2021
Certification dateNovember 3, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEUROLOGY
Medical schoolNEW YORK MEDICAL COLLEGE
Graduated 2016 (10 years in practice)
Group practice Phoenix Rehabilitation And Health Services Inc — 2720 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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