MEDICARE: MICHELLE SONG HEALEY D.O

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	207P00000X	Emergency Medicine Physician	DO-0119	GU
2	207P00000X	Emergency Medicine Physician	82091-21	WI

General Provider Information

NPI Number	:	1215347828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE SONG HEALEY D.O

Provider Business Mailing Address
First Line	:	1638 OWEN DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-3424
Country	:	US
Telephone Number	:	910-615-5095
Fax Number	:

Provider Business Practice Location Address
First Line	:	1638 OWEN DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304
Country	:	US
Telephone Number	:	910-615-5095
Fax Number	:

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

Provider Enumeration Date	:	05/05/2014
Last Update Date	:	02/02/2026

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