Doctor Name: | MR. MICHAEL JAMES SERVICE |
NPI Number: | 1013997535 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | FNP |
License Number: | APN0000006831 |
Business Practice Address: | 2000 Roosevelt Ave Havelock, NC - 285323639 |
Business Phone Number: | 2524660263 |
Business Fax Number: | |
Mailing Address: | 349 Wilson Dr, HAVELOCK |
State: | NC |
Postal Code: | 285323639 |
Phone Number: | 2524442593 |
Fax Number: | |
NPI Enumeration Date: | 01/19/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | APN0000006831 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |