Basic Information
| Provider Information | |||||||||
| NPI: | 1609971068 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GILLESPIE | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | JOSEPH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 205 PAGE RD | ||||||||
| Address2: | |||||||||
| City: | PINEHURST | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283748749 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102955511 | ||||||||
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| Practice Location | |||||||||
| Address1: | 110 FIELDS DR | ||||||||
| Address2: | SUITE A | ||||||||
| City: | SANFORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 273305066 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197779005 | ||||||||
| FaxNumber: | 9197081550 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2006 | ||||||||
| LastUpdateDate: | 01/23/2018 | ||||||||
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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 | 207RC0000X | 2004-00210 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207R00000X | 200400210 | NC | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.