Healthcare Provider Details

I. General information

NPI: 1316543739
Provider Name (Legal Business Name): RICHARD G MICHAL MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2020
Last Update Date: 01/28/2021
Certification Date: 01/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 ENGLISH RD STE 220
ROCKY MOUNT NC
27804-6032
US

IV. Provider business mailing address

804 ENGLISH RD STE 220
ROCKY MOUNT NC
27804-6032
US

V. Phone/Fax

Practice location:
  • Phone: 252-451-7043
  • Fax: 336-933-8278
Mailing address:
  • Phone: 252-451-7043
  • Fax: 336-933-8278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD G. MICHAL
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 252-314-2177