Individual
DR. MICHELLE LISA REDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1404 WILLOW LN, GREENWAY HEALTHCARE, NORTH WILKESBORO, NC 28659-3584
(336) 667-0335
(336) 667-4434
Mailing address
PO BOX 602658, CHARLOTTE, NC 28260-2658
(336) 716-2011
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200001262
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2280816D
MEDICARE, INDIVIDUAL
NC
01
—
2335816
MEDICARE GROUP PTAN
NC
05
—
89127H8
—
NC
Enumeration date
09/29/2006
Last updated
08/01/2017
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