Provider Demographics
NPI:1780664128
Name:DRUCKER, MICHAEL NEIL (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:NEIL
Last Name:DRUCKER
Suffix:
Gender:M
Credentials:MD
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 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-277-2000
Mailing Address - Fax:336-277-2050
Practice Address - Street 1:186 KIMEL PARK DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-6946
Practice Address - Country:US
Practice Address - Phone:336-277-2000
Practice Address - Fax:336-277-2050
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9900823207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC29661OtherPARTNERS ID#
NC1223JOtherBCBS ID#
NC1285682310OtherWSCA GRP NPI #
VA1780664128Medicaid
NC891223JMedicaid
NCBD6441517OtherDEA #
VA1780664128Medicaid
NCNC4152AMedicare PIN
NCG97887Medicare UPIN
NCBD6441517OtherDEA #