Provider Demographics
NPI:1104991991
Name:FINCH, MICHAEL LAVAUGHN (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LAVAUGHN
Last Name:FINCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3332 RICCI LN
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-6575
Mailing Address - Country:US
Mailing Address - Phone:214-868-3209
Mailing Address - Fax:972-351-9343
Practice Address - Street 1:3430 W WHEATLAND RD
Practice Address - Street 2:STE 421
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3406
Practice Address - Country:US
Practice Address - Phone:214-242-9890
Practice Address - Fax:214-242-9905
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2690207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX82480SOtherBCBS
TX103404302Medicaid
TX82480SOtherBCBS
TX82V277Medicare PIN