Provider Demographics
NPI:1891769154
Name:ANTHONY, MICHAEL LAMAR (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:LAMAR
Last Name:ANTHONY
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 1:550 NEW WAVERLY PLACE
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511
Mailing Address - Country:US
Mailing Address - Phone:919-467-5941
Mailing Address - Fax:919-460-7084
Practice Address - Street 1:550 NEW WAVERLY PLACE
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511
Practice Address - Country:US
Practice Address - Phone:919-467-5941
Practice Address - Fax:919-460-7084
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35253207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCF24894OtherWELLPATH
NC0750550OtherUHC
NC11592OtherBCBS
NC562142486OtherBEECHSTREET
NC8911592Medicaid
NC4533414OtherAETNA
NC2674861OtherCIGNA
NC48146OtherMEDCOST
NC48146OtherMEDCOST
NCF24894OtherWELLPATH