Provider Demographics
NPI:1215188297
Name:POPLAK, MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:POPLAK
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 1:5310 NC HIGHWAY 55
Mailing Address - Street 2:SUITE: 102
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-7813
Mailing Address - Country:US
Mailing Address - Phone:972-786-6335
Mailing Address - Fax:919-544-6427
Practice Address - Street 1:5310 NC HIGHWAY 55
Practice Address - Street 2:SUITE: 102
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-7813
Practice Address - Country:US
Practice Address - Phone:972-786-6335
Practice Address - Fax:919-544-6427
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3894111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1063747392OtherCORPORATE
NC1063747392OtherCORPORATE