Provider Demographics
NPI:1053306506
Name:BELL, MICHAEL J
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:BELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CHARLOTTE RADIOLOGY
Mailing Address - Street 2:3030 LATROBE DRIVE
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211
Mailing Address - Country:US
Mailing Address - Phone:704-362-1945
Mailing Address - Fax:704-362-7081
Practice Address - Street 1:CHARLOTTE RADIOLOGY
Practice Address - Street 2:3030 LATROBE DRIVE
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211
Practice Address - Country:US
Practice Address - Phone:704-362-1945
Practice Address - Fax:704-362-7081
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC172382085N0904X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8914581Medicaid
NC204725FMedicare ID - Type Unspecified
NCC87051Medicare UPIN