Provider Demographics
NPI:1033446307
Name:HOGAN, MICHAEL ROBERT-IAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ROBERT-IAN
Last Name:HOGAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 ASHEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786-3441
Mailing Address - Country:US
Mailing Address - Phone:828-246-9555
Mailing Address - Fax:828-246-9556
Practice Address - Street 1:1510 ASHEVILLE RD
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-3441
Practice Address - Country:US
Practice Address - Phone:828-246-9555
Practice Address - Fax:828-246-9556
Is Sole Proprietor?:No
Enumeration Date:2009-11-07
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4014111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2458053OtherMEDICARE - PTAN