Provider Demographics
NPI:1326131053
Name:KREMPASKY, MICAH HOOPER (MD)
Entity Type:Individual
Prefix:DR
First Name:MICAH
Middle Name:HOOPER
Last Name:KREMPASKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MICAH
Other - Middle Name:LINETTE
Other - Last Name:HOOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 603949
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3949
Mailing Address - Country:US
Mailing Address - Phone:919-350-0351
Mailing Address - Fax:919-350-7687
Practice Address - Street 1:3000 NEW BERN AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1231
Practice Address - Country:US
Practice Address - Phone:919-350-7326
Practice Address - Fax:919-350-7204
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1565972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1326131053Medicaid