Healthcare Provider Details

I. General information

NPI: 1942267570
Provider Name (Legal Business Name): MICHAEL JACOB TEAFORD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 12/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 BILTMORE AVE PATHOLOGY DEPT
ASHEVILLE NC
28801
US

IV. Provider business mailing address

PO BOX 419
SYLVA NC
28779-0419
US

V. Phone/Fax

Practice location:
  • Phone: 828-253-0762
  • Fax: 828-254-4892
Mailing address:
  • Phone: 828-366-1150
  • Fax: 828-586-8209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number000026602
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: