Provider Demographics
NPI:1679807044
Name:LOVE, MICHAEL RASHAD (PA-C)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:RASHAD
Last Name:LOVE
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:3010 TRENWEST DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-3208
Mailing Address - Country:US
Mailing Address - Phone:336-718-5844
Mailing Address - Fax:336-970-5298
Practice Address - Street 1:3010 TRENWEST DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3208
Practice Address - Country:US
Practice Address - Phone:336-718-5844
Practice Address - Fax:336-970-5298
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2016-08-26
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Provider Licenses
StateLicense IDTaxonomies
NC0010-01268363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant