| Michael G. Rallis, M.d., Pllc | |
|
2778 Country Club Dr Hampstead NC 28443-8028 | |
| (910) 259-5011 | |
| (910) 259-3060 |
| Full Name | Michael G. Rallis, M.d., Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2778 Country Club Dr, Hampstead, North Carolina |
| Authorized Official Name and Position | Michael George Rallis (OWNER) |
| Authorized Official Contact | 9102595011 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael G. Rallis, M.d., Pllc Po Box 1179 Burgaw NC 28425-1179 Ph: (910) 259-5011 | Michael G. Rallis, M.d., Pllc 2778 Country Club Dr Hampstead NC 28443-8028 Ph: (910) 259-5011 |
| NPI Number | 1477721843 |
|---|---|
| Provider Enumeration Date | 02/19/2008 |
| Last Update Date | 05/03/2022 |
| Medicare PECOS PAC ID | 2365405578 |
|---|---|
| Medicare Enrollment ID | O20200813003229 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477721843 | NPI | - | NPPES |
| 8969959 | Medicaid | NC | |
| 69959 | Other | NC | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 23750 (North Carolina) | Primary |
| Provider Name | Michael George Rallis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821151069 PECOS PAC ID: 9032172242 Enrollment ID: I20041109000546 |
| Provider Name | Emily B Rivenbark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639454598 PECOS PAC ID: 4183898729 Enrollment ID: I20111117000355 |
| Provider Name | Rebecca Wells Denson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942484704 PECOS PAC ID: 9638351497 Enrollment ID: I20130415000152 |
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