Healthcare Provider Details

I. General information

NPI: 1649532110
Provider Name (Legal Business Name): MICHAEL DAVID RIGBY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2012
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4123 LAWNDALE DR STE 105
GREENSBORO NC
27455-1827
US

IV. Provider business mailing address

4123 LAWNDALE DR STE 105
GREENSBORO NC
27455-1827
US

V. Phone/Fax

Practice location:
  • Phone: 336-365-0001
  • Fax: 877-407-9249
Mailing address:
  • Phone: 336-365-0001
  • Fax: 877-407-9249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number2015-00038
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: