MEDICARE: MRS. MICHELE DUVAL NACOUZI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	9500164	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	61907	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1326024498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELE DUVAL NACOUZI M.D.

Provider Business Mailing Address
First Line	:	7021 HARPS MILL RD
Second Line	:	STE 100
City	:	RALEIGH
State	:	NC
Zip	:	27615-3240
Country	:	US
Telephone Number	:	919-620-4855
Fax Number	:

Provider Business Practice Location Address
First Line	:	10211 ALM ST
Second Line	:	SUITE 1100
City	:	RALEIGH
State	:	NC
Zip	:	27617-8221
Country	:	US
Telephone Number	:	919-484-8345
Fax Number	:	919-419-8218

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2005
Last Update Date	:	03/31/2021

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Directions to “ MRS. MICHELE DUVAL NACOUZI M.D.” Practice Location

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