Provider Demographics
NPI:1316543739
Name:RICHARD G MICHAL MD PLLC
Entity Type:Organization
Organization Name:RICHARD G MICHAL MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:MICHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-314-2177
Mailing Address - Street 1:804 ENGLISH RD STE 220
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-6032
Mailing Address - Country:US
Mailing Address - Phone:252-451-7043
Mailing Address - Fax:336-933-8278
Practice Address - Street 1:804 ENGLISH RD STE 220
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-6032
Practice Address - Country:US
Practice Address - Phone:252-451-7043
Practice Address - Fax:336-933-8278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-10
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty