Provider Demographics
NPI:1881761146
Name:STRIBLING, MICHAEL DEAN (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DEAN
Last Name:STRIBLING
Suffix:
Gender:M
Credentials:MD
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 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:864-489-6864
Mailing Address - Fax:864-489-1477
Practice Address - Street 1:472 RANKIN DR
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-6568
Practice Address - Country:US
Practice Address - Phone:659-570-0828
Practice Address - Fax:828-659-5785
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33432208800000X
SC30394208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC194802OtherMEDCOST
NC80347OtherBLUE CROSS
NC8980347Medicaid
NC19222OtherUMWA
SC303941Medicaid
SC303941Medicaid
NC213270BMedicare PIN
SC24502815Medicare PIN