Individual
MR. MICHAEL DIAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
250 SMITH CHURCH RD, ROANOKE RAPIDS, NC 27870-4914
(252) 535-8011
Mailing address
2100 STANTONSBURG RD, GREENVILLE, NC 27834-2818
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
103519
NC
363AM0700X
Medical Physician Assistant
Primary
103519
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7436706
AETNA ID
NC
01
—
D2840
MEDCOST ID
NC
Enumeration date
06/02/2005
Last updated
01/20/2022
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