Provider Demographics
NPI:1336108364
Name:PARKER, MICHAEL EARL (MD,MPH)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:EARL
Last Name:PARKER
Suffix:
Gender:M
Credentials:MD,MPH
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5183 BLACKHAWK RD.
Mailing Address - Street 2:HEADQUARTERS, 20TH SUPPORT CMD,AFCB-MB (ATTN: SURGEON)
Mailing Address - City:ABERDEEN PROVING GROUND
Mailing Address - State:MD
Mailing Address - Zip Code:21010-5424
Mailing Address - Country:US
Mailing Address - Phone:410-436-4603
Mailing Address - Fax:
Practice Address - Street 1:5183 BLACK HAWK RD
Practice Address - Street 2:20TH SUPPORT CMD, AFCB-MD (ATTN: SURGEON)
Practice Address - City:ABERDEEN PROVING GROUND
Practice Address - State:MD
Practice Address - Zip Code:21010-5424
Practice Address - Country:US
Practice Address - Phone:410-436-4603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12808R2083P0500X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine