Provider Demographics
NPI:1609877901
Name:ESTRAMONTE, MICHAEL HUGH (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HUGH
Last Name:ESTRAMONTE
Suffix:
Gender:M
Credentials:DC
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 667948
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28266-7948
Mailing Address - Country:US
Mailing Address - Phone:704-392-1338
Mailing Address - Fax:704-392-8156
Practice Address - Street 1:402 E SUGAR CREEK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-6913
Practice Address - Country:US
Practice Address - Phone:704-598-8225
Practice Address - Fax:704-598-2433
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2784111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890842PMedicaid
NC890842PMedicaid
NC2453978Medicare ID - Type Unspecified