Provider Demographics
NPI:1265661391
Name:MICHAELS, CHASE ANDERSON (PA-C)
Entity Type:Individual
Prefix:
First Name:CHASE
Middle Name:ANDERSON
Last Name:MICHAELS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7779 NC HIGHWAY 68 N STE 2A
Mailing Address - Street 2:
Mailing Address - City:STOKESDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27357-9496
Mailing Address - Country:US
Mailing Address - Phone:336-298-7557
Mailing Address - Fax:336-298-7551
Practice Address - Street 1:7779 NC HIGHWAY 68 N STE 2A
Practice Address - Street 2:
Practice Address - City:STOKESDALE
Practice Address - State:NC
Practice Address - Zip Code:27357-9496
Practice Address - Country:US
Practice Address - Phone:336-298-7557
Practice Address - Fax:362-987-5513
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-02239363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2762230Medicare PIN