Provider Demographics
NPI:1689791410
Name:MESSICK, MICHAEL W
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:W
Last Name:MESSICK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 FLINT RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-9275
Mailing Address - Country:US
Mailing Address - Phone:704-721-6754
Mailing Address - Fax:866-390-4777
Practice Address - Street 1:146 FLINT RIDGE DR
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-9275
Practice Address - Country:US
Practice Address - Phone:704-721-6754
Practice Address - Fax:866-390-4777
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies