MEDICARE: DENISE LITTLES MICHEL 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	2084P0800X	Psychiatry Physician	2015-02097	NC
2	390200000X	Student in an Organized Health Care Education/Training Program
3	2084P0800X	Psychiatry Physician	ME106811	FL

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

General Provider Information

NPI Number	:	1700076627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE LITTLES MICHEL MD

Provider Business Mailing Address
First Line	:	3157 GROVESHIRE DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27616-8397
Country	:	US
Telephone Number	:	919-578-9103
Fax Number	:	919-267-1589

Provider Business Practice Location Address
First Line	:	6739 FALLS OF NEUSE RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27615-5305
Country	:	US
Telephone Number	:	919-578-9103
Fax Number	:

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

Provider Enumeration Date	:	07/26/2007
Last Update Date	:	03/08/2022

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