Healthcare Provider Details

I. General information

NPI: 1700010394
Provider Name (Legal Business Name): MICHAEL DREW HONAKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2009
Last Update Date: 02/02/2023
Certification Date: 02/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 MOYE BLVD STE 4S-24
GREENVILLE NC
27834-4300
US

IV. Provider business mailing address

800 1ST ST STE 240
MACON GA
31201-8300
US

V. Phone/Fax

Practice location:
  • Phone: 252-744-4110
  • Fax:
Mailing address:
  • Phone: 478-633-6900
  • Fax: 478-633-2175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number074466
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2020-04575
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number074466
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number2020-04575
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: