Provider Demographics
NPI:1326418922
Name:SISSKIND, MICHAEL M
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:M
Last Name:SISSKIND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8652 PINEVILLE MATTHEWS RD STE 1050
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-4747
Mailing Address - Country:US
Mailing Address - Phone:704-541-8965
Mailing Address - Fax:
Practice Address - Street 1:8652 PINEVILLE MATTHEWS RD STE 1050
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-4747
Practice Address - Country:US
Practice Address - Phone:704-541-8965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist