Mattingly, Michael T

Mattingly, Michael T is an individual health care provider with primary practice located at 309 New St , Greensboro NC 27405-3654. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Mattingly, Michael T can be contacted via phone (336) 379-9708.

Contact Information

Primary practice address
309 New St Greensboro NC 27405-3654
Phone: (336) 379-9708
Fax: (336) 379-8714
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 9500996 North Carolina

Profile Details

NPI number 1477592673
LBN Legal business name Mattingly, Michael T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2006
Last updated May 20th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477592673 NPPES
North Carolina Other 390004560 RRM PROVIDER #
North Carolina Other 19495 RRM PROVIDER #
North Carolina Other 1036N RRM PROVIDER #
North Carolina Other 561274347 RRM PROVIDER #
North Carolina MEDICAID 891036N RRM PROVIDER #
North Carolina Other 3102727 RRM PROVIDER #

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