Individual
DR. MICHAEL O CITRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8406 SIX FORKS RD, SUITE 101, RALEIGH, NC 27615-3074
(919) 740-6129
Mailing address
8308 NANTAHALA DR, RALEIGH, NC 27612-7336
(919) 571-8137
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
9500043
NC
208D00000X
General Practice Physician
95-00043
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080094382
RR MEDICARE
NC
01
—
69637
BLUE SHIELD
NC
05
—
8922602
—
NC
05
—
8969637
—
NC
Enumeration date
09/25/2006
Last updated
03/07/2023
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