Provider Demographics
NPI:1013972587
Name:STUTESMAN, MICHAEL S (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:STUTESMAN
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 1:607 E PARKER RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-8105
Mailing Address - Country:US
Mailing Address - Phone:828-433-0225
Mailing Address - Fax:828-437-0227
Practice Address - Street 1:607 E PARKER RD
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-8105
Practice Address - Country:US
Practice Address - Phone:828-433-0225
Practice Address - Fax:828-437-0227
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25449207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7980746Medicaid
C87687Medicare UPIN
212800BMedicare ID - Type Unspecified