1497894927 NPI number — MICHAEL P BATTAGLINO MD

Table of content: MICHAEL P BATTAGLINO MD (NPI 1497894927)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497894927 NPI number — MICHAEL P BATTAGLINO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BATTAGLINO
Provider First Name:
MICHAEL
Provider Middle Name:
P
Provider Name Prefix Text:
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:
1497894927
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/11/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 18563
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RALEIGH
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27619-8563
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-782-1806
Provider Business Mailing Address Fax Number:
919-782-1669

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2601 LAKE DR
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
RALEIGH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27607-6688
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-783-4888
Provider Business Practice Location Address Fax Number:
919-783-4887
Provider Enumeration Date:
02/05/2007

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:  9801160 , 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: 8057871 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2956182 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1752215 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 96555 . This is a "MEDCOST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100014320 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 891263W , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1263W . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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