Provider Demographics
NPI:1508958893
Name:FLECK, MICHAEL SCOT (PA-C)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:SCOT
Last Name:FLECK
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 VANDERBILT PARK DR FL 2
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1700
Mailing Address - Country:US
Mailing Address - Phone:288-255-7776
Mailing Address - Fax:828-225-2631
Practice Address - Street 1:7 VANDERBILT PARK DR FL 2
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1700
Practice Address - Country:US
Practice Address - Phone:288-255-7776
Practice Address - Fax:828-225-2631
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC001005844363AS0400X
NC0010-05844363A00000X
GA004004363A00000X, 363AS0400X
CT003926363AS0400X
NMPA2020-0043363AS0400X
CA55450363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP81403Medicare UPIN
GA97WCJDHMedicare ID - Type Unspecified