Provider Demographics
NPI:1427091263
Name:TEPEDINO, MICHAEL EMILE (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:EMILE
Last Name:TEPEDINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1701 WESTCHESTER DR
Mailing Address - Street 2:STE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7254
Mailing Address - Country:US
Mailing Address - Phone:336-802-2400
Mailing Address - Fax:336-802-2001
Practice Address - Street 1:307 LINDSAY ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-4827
Practice Address - Country:US
Practice Address - Phone:336-802-2020
Practice Address - Fax:336-802-2021
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9300607207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC180024763OtherRR MEDICARE
NC8982421Medicaid
F53484Medicare UPIN
NC2191311BMedicare PIN