Healthcare Provider Details

I. General information

NPI: 1306223177
Provider Name (Legal Business Name): MAJD MICHAEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2015
Last Update Date: 08/26/2021
Certification Date: 08/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 PALMER DR STE 201
CAMERON PARK CA
95682-8276
US

IV. Provider business mailing address

4305 SILVER LUPINE DR
TURLOCK CA
95382-9310
US

V. Phone/Fax

Practice location:
  • Phone: 832-712-7053
  • Fax:
Mailing address:
  • Phone: 832-712-7053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA151364
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: