Provider Demographics
NPI:1700076627
Name:MICHEL, DENISE LITTLES (MD)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:LITTLES
Last Name:MICHEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:VANESSA
Other - Last Name:LITTLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3157 GROVESHIRE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-8397
Mailing Address - Country:US
Mailing Address - Phone:919-578-9103
Mailing Address - Fax:919-267-1589
Practice Address - Street 1:6739 FALLS OF NEUSE RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5305
Practice Address - Country:US
Practice Address - Phone:919-578-9103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2015-020972084P0800X
390200000X
FLME1068112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002126500Medicaid