Provider Demographics
NPI:1073533246
Name:KALISH, MICHAEL JOHN (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOHN
Last Name:KALISH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1701 WESTCHESTER DRIVE
Mailing Address - Street 2:SUITE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7254
Mailing Address - Country:US
Mailing Address - Phone:336-802-2400
Mailing Address - Fax:336-802-2534
Practice Address - Street 1:4515 PREMIER DR
Practice Address - Street 2:SUITE 201
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-8357
Practice Address - Country:US
Practice Address - Phone:336-802-2610
Practice Address - Fax:336-802-2611
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2015-03-06
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Provider Licenses
StateLicense IDTaxonomies
NC30924207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC080083331OtherRR MEDICARE
NC1212660012OtherDME
NC8947764Medicaid
D92838Medicare UPIN
NC080083331OtherRR MEDICARE