Provider Demographics
NPI:1285701466
Name:HELLER, MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:HELLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ISRAEL
Other - Middle Name:MEYER
Other - Last Name:HELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 647
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-0647
Mailing Address - Country:US
Mailing Address - Phone:910-483-7337
Mailing Address - Fax:910-483-0648
Practice Address - Street 1:55 MEDICAL PARK DR
Practice Address - Street 2:SUITE 114
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-2651
Practice Address - Country:US
Practice Address - Phone:828-524-7337
Practice Address - Fax:828-369-4241
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201101510208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5918837Medicaid
NC1930OtherHEALTHNET FEDERAL SERVICES / TRICARE
NC238027OtherMEDCOST LLC
NC2720287OtherUNITED HEALTHCARE
NC1653ROtherBCBS OF NC
NC7696903OtherAETNA