Healthcare Provider Details
I. General information
NPI: 1720198815
Provider Name (Legal Business Name): MICHAEL IRA TURK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/30/2006
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13815 PROFESSIONAL CENTER DR STE 100
HUNTERSVILLE NC
28078-7951
US
IV. Provider business mailing address
PO BOX 60447
CHARLOTTE NC
28260-0447
US
V. Phone/Fax
- Phone: 704-384-1320
- Fax: 704-316-3138
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | MD426773 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 2024-00868 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: