Provider Demographics
NPI:1255396057
Name:INMAN, MICHAEL PARKER (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PARKER
Last Name:INMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6676 CRAVEN HILL WAY
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-8306
Mailing Address - Country:US
Mailing Address - Phone:239-249-1224
Mailing Address - Fax:239-348-2351
Practice Address - Street 1:6676 CRAVEN HILL WAY
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-8306
Practice Address - Country:US
Practice Address - Phone:239-249-1224
Practice Address - Fax:239-348-2351
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8987103T00000X
AR92-27P103TR0400X
AR103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR138850719Medicaid
AROTH000Medicare UPIN
AR138850719Medicaid