Provider Demographics
NPI:1881660363
Name:MEADORS, MICHAEL CRAIG (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:CRAIG
Last Name:MEADORS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 75216
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-0216
Mailing Address - Country:US
Mailing Address - Phone:336-718-6777
Mailing Address - Fax:336-718-6773
Practice Address - Street 1:1901 S HAWTHORNE RD STE 220
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3914
Practice Address - Country:US
Practice Address - Phone:336-718-6777
Practice Address - Fax:336-718-6773
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200101476207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1881660363Medicaid
NC891300VMedicaid
NC290014620OtherRAILROAD MEDICARE
NC2219725FMedicare PIN
NC290014620OtherRAILROAD MEDICARE
NC891300VMedicaid
NC2219725GMedicare PIN