Provider Demographics
NPI:1982847117
Name:MASTERMAN, MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:MASTERMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 TOWN SQUARE BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-5066
Mailing Address - Country:US
Mailing Address - Phone:828-209-1900
Mailing Address - Fax:866-340-8808
Practice Address - Street 1:30 TOWN SQUARE BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-5066
Practice Address - Country:US
Practice Address - Phone:828-209-1900
Practice Address - Fax:866-340-8808
Is Sole Proprietor?:No
Enumeration Date:2009-04-17
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7391111N00000X
NC3928111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55622Medicare UPIN