Individual
MICHAEL THOMAS CONSTANTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.O.
Contact information
Practice address
744 HARTNESS RD, STATESVILLE, NC 28677-3425
(704) 878-9168
(704) 871-0655
Mailing address
744 HARTNESS RD, STATESVILLE, NC 28677-3425
(704) 878-9168
(704) 871-0655
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7702812
—
NC
Enumeration date
12/05/2007
Last updated
12/05/2007
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