Provider Demographics
NPI:1265430078
Name:BELL, MICHAEL JOSEPH (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:BELL
Suffix:
Gender:M
Credentials:DO
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 743070
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-3070
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:1200 E MAIN ST STE 12
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307-1738
Practice Address - Country:US
Practice Address - Phone:864-560-9260
Practice Address - Fax:864-560-9265
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1061207Q00000X, 207P00000X
NC29980207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCN29980Medicaid
NCP00284179OtherRAILROAD MEDICARE B
SCSC97136067OtherMEDICARE PIN
NC5901575Medicaid
SC198715OtherMEDCOST
SCSC9713J577OtherMEDICARE PIN
NC138VMOtherBCBS
SC20063493OtherSELECT HEALTH
SCSC97136121OtherMEDICARE PTN
NCC82779Medicare UPIN
SCN29980Medicaid
SCSC97136121OtherMEDICARE PIN
SCC827799068Medicare PIN
SC198715OtherMEDCOST
SCSC97136121OtherMEDICARE PTN