MEDICARE: MRS. KRISTEN NICOLE MICHAEL D.O.

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	DO.1599	AL
2	207QS0010X	Sports Medicine (Family Medicine) Physician	DO.1599	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982970232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTEN NICOLE MICHAEL D.O.

Provider Business Mailing Address
First Line	:	995 9TH AVE SW
Second Line	:	MEDICAL STAFF OFFICE
City	:	BESSEMER
State	:	AL
Zip	:	35022-4527
Country	:	US
Telephone Number	:	205-481-7312
Fax Number	:	205-481-7593

Provider Business Practice Location Address
First Line	:	1179 GREENMOR DR
Second Line	:
City	:	BESSEMER
State	:	AL
Zip	:	35022-6445
Country	:	US
Telephone Number	:	205-481-8530
Fax Number	:	205-424-6543

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

Provider Enumeration Date	:	03/30/2012
Last Update Date	:	03/20/2017

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Directions to “ MRS. KRISTEN NICOLE MICHAEL D.O.” Practice Location

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