Provider Demographics
NPI:1255316329
Name:MEIGHEN, MICHAEL JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOHN
Last Name:MEIGHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:695 HARRISON DR NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-4537
Mailing Address - Country:US
Mailing Address - Phone:704-785-1301
Mailing Address - Fax:
Practice Address - Street 1:695 HARRISON DR NW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-4537
Practice Address - Country:US
Practice Address - Phone:704-785-1301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN65319208100000X
NC97003332081S0010X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1115YOtherBCBS OF NC
MN1255316329Medicaid
5990752OtherAETNA
250012586OtherRAILROAD MEDICARE
1115YOtherBCBS OF NC
SCQ0033JMedicaid
419807OtherONE HEALTH PLAN
581459795023OtherPRUDENTIAL
2343420OtherUNITED HEALTHCARE
46582OtherPARTNERS MEDICARE
98537OtherMEDCOST
2443613OtherEATNA US HEALTHCARE
8913936004OtherCIGNA HEALTHCARE
NC2280582Medicare ID - Type Unspecified
250012586OtherRAILROAD MEDICARE
692538Medicare UPIN