Provider Demographics
NPI:1023055761
Name:PRITCHETT, MICHAEL A (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:PRITCHETT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 PAGE ROAD
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-8798
Mailing Address - Country:US
Mailing Address - Phone:910-295-5511
Mailing Address - Fax:
Practice Address - Street 1:205 PAGE ROAD
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8798
Practice Address - Country:US
Practice Address - Phone:910-295-9359
Practice Address - Fax:910-235-3401
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2008-01402207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00644090OtherRAILROAD MEDICARE
FH2967645OtherFIRSTCAROLINACARE
SCN01408OtherSC MEDICAID
1498ROtherBCBS NC
NC5910122Medicaid
2401663Medicare PIN