Healthcare Provider Details

I. General information

NPI: 1326051939
Provider Name (Legal Business Name): MICHAEL DELEON GAITHER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2805 S MAIN ST
HIGH POINT NC
27263-1936
US

IV. Provider business mailing address

2805 S MAIN ST
HIGH POINT NC
27263-1936
US

V. Phone/Fax

Practice location:
  • Phone: 336-883-0029
  • Fax: 336-883-0867
Mailing address:
  • Phone: 336-883-0029
  • Fax: 336-883-0867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number102037015
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1205
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number9600917
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: