MEDICARE: MICHAEL N TATE MD

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	207RH0003X	Hematology & Oncology Physician	27407	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	81644	OTHER	NC	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366445686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL N TATE MD

Provider Business Mailing Address
First Line	:	PO BOX 3710
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28603-3710
Country	:	US
Telephone Number	:	828-324-9550
Fax Number	:	828-324-4154

Provider Business Practice Location Address
First Line	:	2406 CENTURY PL SE
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28602-4031
Country	:	US
Telephone Number	:	828-324-9550
Fax Number	:	828-324-4154

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	11/23/2009

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Directions to “ MICHAEL N TATE MD” Practice Location

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