MEDICARE: ROBERT E MCMICHAEL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	G4652	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	130010890	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	89M400	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1205985934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT E MCMICHAEL M.D.

Provider Business Mailing Address
First Line	:	2800 E BROAD ST
Second Line	:	SUITE 504
City	:	MANSFIELD
State	:	TX
Zip	:	76063-6409
Country	:	US
Telephone Number	:	817-225-0410
Fax Number	:	817-419-0422

Provider Business Practice Location Address
First Line	:	1741 E BARDIN RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76018-4836
Country	:	US
Telephone Number	:	817-702-8700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	05/28/2024

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Directions to “ ROBERT E MCMICHAEL M.D.” Practice Location

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