Individual
MICHAEL THOMAS FITCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
200201077
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10076501
—
VA
01
—
1365X
BCBS
—
05
—
3810000122
—
WV
01
—
7679690
AETNA
—
01
—
804454
PARTNERS
—
05
—
891365X
—
NC
01
—
D5396
MEDCOST
—
05
—
Q01077
—
SC
Enumeration date
11/30/2005
Last updated
06/29/2010
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