1932185956 NPI number — DR. MICHAEL DIXON MCKAY MD

Table of content: (NPI 1689191611)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932185956 NPI number — DR. MICHAEL DIXON MCKAY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCKAY
Provider First Name:
MICHAEL
Provider Middle Name:
DIXON
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932185956
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/09/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2417 ATRIUM DR
Provider Second Line Business Mailing Address:
SUITE 150
Provider Business Mailing Address City Name:
RALEIGH
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27607-6673
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-791-2040
Provider Business Mailing Address Fax Number:
919-791-2041

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2417 ATRIUM DR
Provider Second Line Business Practice Location Address:
SUITE 150
Provider Business Practice Location Address City Name:
RALEIGH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27607-6673
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-791-2040
Provider Business Practice Location Address Fax Number:
919-791-2041
Provider Enumeration Date:
12/21/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X , with the licence number:  31333 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7813265 . This is a "CIGNA" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 56962 . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 110204543 . This is a "RAILROAD MEDIARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 2950432 . This is a "UNITED" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 8956962 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 30626 . This is a "PARTNERS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 289324 . This is a "MAMSI" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 4221557 . This is a "AETNA" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 95075 . This is a "MEDCOST" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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