Mary L Michal, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD0000003984 Issued in TN

Practice address

302 Wesley St
Ste 10
Johnson City, TN 37601-1740

Phone

(423) 928-9007

Fax

(423) 928-9249

NPI assigned

Aug 4, 2005

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Michal Child Development Center

  • Specialist
  • Johnson City, TN
  • NPI 1417128968
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1275534810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 FAIRWAY DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 WESLEY ST",
            "address_2": "STE 10",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011740",
            "telephone_number": "423-928-9007",
            "fax_number": "423-928-9249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAL",
        "first_name": "MARY",
        "middle_name": "L",
        "name_prefix": "Miss",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-04",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD0000003984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6738371",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6906086",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3846544",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Basundhara Mete, MBBS
• Ray Wallace Mettetal Jr., M.D.
• Kevin Allen Metzger, D.O.
• Frances Nicole Meyer, BSW
• Karen Meyer
• Microbac Healthcare Services, LLC
• Anthony James Midkiff, PA-C
• Matthew M Midkiff, LPC, MHSP
• Jennifer Michelle Miles, PHARMD
• Judy Anne Miles, BSW

• Specialist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.