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Individual

DR. MICHAEL ROYCE PENLAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
5002-1 HEWLETTS RUN, WILMINGTON, NC 28409
(828) 230-6749
(910) 399-5628
Mailing address
5002-1 HEWLETTS RUN, WILMINGTON, NC 28409
(828) 230-6749
(910) 399-5628

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1902
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0441M
BCBSNC
NC
01
2021303,
CIGNA BEHAVIORAL HEALTH
NC
05
6000769
NC
01
9406987
AETNA BEHAVIORAL HEALTH
NC
01
P01192383
RR MEDICARE
NC
Enumeration date
02/27/2008
Last updated
08/07/2018
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