Healthcare Provider Details

I. General information

NPI: 1467515247
Provider Name (Legal Business Name): MICHELLE SCHWEITZER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 03/06/2020
Certification Date: 03/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 SUNNYBROOK RD STE 200
RALEIGH NC
27610-1855
US

IV. Provider business mailing address

3024 NEW BERN AVE STE 307
RALEIGH NC
27610-1247
US

V. Phone/Fax

Practice location:
  • Phone: 919-350-8797
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number300367
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number300367
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number300367
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: