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Provider Information for 1558409326


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Dr. MICHAEL ULRICH AFFEMANN Ph.D.


Sex: Male

NPI: 1558409326
Last Updated: 2007-07-09
Certification Date:

Details

NameValue
NPI1558409326
Enumeration Date2007-02-02
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address PO BOX 505
KURE BEACH, NC 28449-0505
United States

Phone: 910-458-5675 | Fax:
 
Primary Practice Address 205 RALEIGH AVE
CAROLINA BEACH, NC 28428-4904
United States

Phone: 910-458-5675 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 103T00000X - Psychologist NC1491