Provider Demographics
NPI:1598925166
Name:LINKOUS, MICHELLE CHIDESTER (DO)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:CHIDESTER
Last Name:LINKOUS
Suffix:
Gender:F
Credentials:DO
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 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:167 MOORE RD STE 201
Practice Address - Street 2:
Practice Address - City:KING
Practice Address - State:NC
Practice Address - Zip Code:27021-8770
Practice Address - Country:US
Practice Address - Phone:336-673-6470
Practice Address - Fax:336-673-6489
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2011-00534208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5918174Medicaid
NCNC1338AMedicare PIN