Healthcare Provider Details

I. General information

NPI: 1124023510
Provider Name (Legal Business Name): MICHAEL JOHN VARNEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2085 FRONTIS PLAZA BLVD
WINSTON SALEM NC
27103-5614
US

IV. Provider business mailing address

PO BOX 749306
ATLANTA GA
30374-9306
US

V. Phone/Fax

Practice location:
  • Phone: 704-316-4136
  • Fax:
Mailing address:
  • Phone: 843-663-2220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number33319
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number16343
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number33319
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: