Basic Information
| Provider Information | |||||||||
| NPI: | 1700825270 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REY | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | T | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3282 | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288023282 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 18 WEDGEFIELD DR | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288062226 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282528748 | ||||||||
| FaxNumber: | 8282529512 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2006 | ||||||||
| LastUpdateDate: | 07/30/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 26358 | NC | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | 26358 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine | 208D00000X | 30731 | NC | N | Allopathic & Osteopathic Physicians | General Practice |
ID Information
| ID | Type | State | Issuer | Description | 89132U8 | 05 | NC | MEDICAID | 132U8 | 01 | NC | BCBS | OTHER | Q26358 | 05 | SC | MEDICAID |