MEDICARE: DR. MICHAEL RAY OWENS 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	207R00000X	Internal Medicine Physician	2007-01543	NC

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306874649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL RAY OWENS M.D.

Provider Business Mailing Address
First Line	:	19 SYPHRONA CIR
Second Line	:
City	:	CLAYTON
State	:	NC
Zip	:	27527-7055
Country	:	US
Telephone Number	:	724-304-8200
Fax Number	:

Provider Business Practice Location Address
First Line	:	19 SYPHRONA CIR
Second Line	:
City	:	CLAYTON
State	:	NC
Zip	:	27527-7055
Country	:	US
Telephone Number	:	724-304-8200
Fax Number	:

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	07/22/2023

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