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NPI Code Detail

MEDICARE: MIKAH SHERIDAN THOMPSON M.D.

MEDICARE: MIKAH SHERIDAN THOMPSON 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
1208000000XPediatrics Physician2025-03825NC
2208000000XPediatrics PhysicianME129445FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558531335
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIKAH SHERIDAN THOMPSON M.D.
Provider Business Mailing Address
First Line : PO BOX 110566
Second Line :
City : DURHAM
State : NC
Zip : 27709-5566
Country : US
Telephone Number : 919-668-4000
Fax Number :
Provider Business Practice Location Address
First Line : 2301 ERWIN RD
Second Line :
City : DURHAM
State : NC
Zip : 27705-4699
Country : US
Telephone Number : 919-668-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2008
Last Update Date : 05/04/2026

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