Provider Demographics
NPI:1497946685
Name:SAAVEDRA, MICHAEL CARL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CARL
Last Name:SAAVEDRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 603725
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3725
Mailing Address - Country:US
Mailing Address - Phone:828-575-2625
Mailing Address - Fax:828-350-2174
Practice Address - Street 1:11645 ANGUS RD STE A1
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4100
Practice Address - Country:US
Practice Address - Phone:512-345-7635
Practice Address - Fax:512-345-1649
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1115207K00000X, 207K00000X
AZ42415207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1P5036OtherPTAN
AZZ133333Medicare PIN
AZZ150949Medicare PIN