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Individual
MR. MICHAEL JOHN MODROW
Active
Individual
MR. MICHAEL JOHN MODROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1032066
NC
363AS0400X
Surgical Physician Assistant
Primary
102199
NC
Other
Enumeration date
05/31/2008
Last updated
03/09/2021
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