Provider Demographics
NPI:1942267570
Name:TEAFORD, MICHAEL JACOB (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JACOB
Last Name:TEAFORD
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 419
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-0419
Mailing Address - Country:US
Mailing Address - Phone:828-366-1150
Mailing Address - Fax:828-586-8209
Practice Address - Street 1:509 BILTMORE AVE
Practice Address - Street 2:PATHOLOGY DEPT
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801
Practice Address - Country:US
Practice Address - Phone:828-253-0762
Practice Address - Fax:828-254-4892
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC000026602207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC82333OtherBCBS NC
NC8982333Medicaid
NCP00333456OtherRR MEDICARE
NC213333BMedicare PIN
D92849Medicare UPIN