Provider Demographics
NPI:1437155199
Name:MICHALOVE, PAUL DAVID (OD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DAVID
Last Name:MICHALOVE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 MERRIMON AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-3408
Mailing Address - Country:US
Mailing Address - Phone:828-254-3230
Mailing Address - Fax:828-258-2232
Practice Address - Street 1:508 MERRIMON AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-3408
Practice Address - Country:US
Practice Address - Phone:828-254-3230
Practice Address - Fax:828-258-2232
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0823152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC09613OtherBCBS
NC246030BMedicare PIN
NC09613OtherBCBS