Individual
DOUGLAS MICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
305 1ST ST E, CONOVER, NC 28613-1715
(828) 464-3821
(828) 464-8994
Mailing address
PO BOX 249, CONOVER, NC 28613-0249
(828) 465-9730
(828) 465-9293
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
25060
NC
207Q00000X
Family Medicine Physician
Primary
25060
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8958778
—
NC
01
—
CN8132
MEDICARE RAILROAD
NC
Enumeration date
01/20/2006
Last updated
03/07/2023
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