Mickey, Adam Dean
Mickey, Adam Dean is an individual health care provider with primary practice located at 2242 W Roosevelt Blvd Ste A , Monroe NC 28110. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Mickey, Adam Dean can be contacted via phone (704) 220-1904.Contact Information
Primary practice address
2242 W Roosevelt Blvd Ste A
Monroe NC 28110
Phone: (704) 220-1904
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA9108348 | Florida |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 0010-07049 | North Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 0010-07049 | North Carolina |
Profile Details
| NPI number | 1073917209 |
|---|---|
| LBN Legal business name | Mickey, Adam Dean |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 17th, 2014 |
| Last updated | Jun 10th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073917209 | NPPES |
| Georgia | MEDICAID | 003156207A | |
| Georgia | MEDICAID | 013627200 |
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