Provider Demographics
NPI:1629025606
Name:PARKER, MICHELLE E (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:E
Last Name:PARKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:H
Other - Last Name:ELIUK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2699
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32513-2699
Mailing Address - Country:US
Mailing Address - Phone:850-475-4500
Mailing Address - Fax:
Practice Address - Street 1:12805 HWY 98
Practice Address - Street 2:G201
Practice Address - City:INLET BEACH
Practice Address - State:FL
Practice Address - Zip Code:32461-4713
Practice Address - Country:US
Practice Address - Phone:850-278-3466
Practice Address - Fax:850-278-3467
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA132380207R00000X
FLME132380207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH78279Medicare UPIN
GA11SCGSGMedicare PIN