Individual
DR. MICHAEL MICHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
109 BURTON AVE, SUITE E, SUMMERVILLE, SC 29485-8117
(843) 875-8994
Mailing address
109 BURTON AVE, SUITE E, SUMMERVILLE, SC 29485-8117
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME 104400
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001212500
—
FL
01
—
145JW
BLUE CROSS BLUE SHIELD
FL
Enumeration date
11/20/2007
Last updated
01/27/2022
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