Provider Demographics
NPI:1669437539
Name:MILTICH, MICHAEL FIEGEL (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:FIEGEL
Last Name:MILTICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6035 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3256
Mailing Address - Country:US
Mailing Address - Phone:704-295-3000
Mailing Address - Fax:704-295-3468
Practice Address - Street 1:10512 PARK RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8475
Practice Address - Country:US
Practice Address - Phone:704-295-3650
Practice Address - Fax:704-295-3666
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26963207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC10470OtherKANAWHA
NC561896112KOtherCIGNA
SCN26963Medicaid
NC141012OtherCOVENTRY
NC4024096OtherAETNA
NC6197OtherDOCTORS HEALTH PLAN
NC276577OtherMAMSI
NC28217OtherMEDCOST
SC000000260101OtherUNISON HEALTH PLAN SC
NC1041441OtherUNITED HEALTHCARE
NC7105OtherWELLPATH
SC20034344OtherSELECT HEALTH OF SC
NC100765OtherWELLNESS
NC8959509Medicaid
NC59509OtherBCBS
NC6864OtherPARTNERS
NC4024096OtherAETNA
NC561896112KOtherCIGNA
NC8959509Medicaid