Provider Demographics
NPI:1457355406
Name:MICHAEL, STEVEN P (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:P
Last Name:MICHAEL
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 2400
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42241-2400
Mailing Address - Country:US
Mailing Address - Phone:270-887-0100
Mailing Address - Fax:
Practice Address - Street 1:155 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8710
Practice Address - Country:US
Practice Address - Phone:910-715-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY03774207R00000X
NC200100910207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC260645258OtherCOMMERCIAL
NCD8733OtherMEDCOST
NC26-0645258OtherTRICARE
NC5869566OtherCIGNA
KY7100383910Medicaid
NCP00188985OtherRAILROAD MEDICARE
NC1104018779OtherCOMMERCIAL
NC1104018779Medicaid
NC129M4OtherBCBS NC
NC89129M4Medicaid
NC1104018779OtherBCBS
NCP00419757OtherRAILROAD MEDICARE
NCP00419757OtherRAILROAD MEDICARE
KY7100383910Medicaid
NC2401187BMedicare PIN
NC1104018779OtherBCBS
NC260645258OtherCOMMERCIAL