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NPI Code Detail

MEDICARE: MICHELLE CATHERINE LYNAM M.D.

MEDICARE: MICHELLE CATHERINE LYNAM M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology PhysicianBL8255627VA
2207L00000XAnesthesiology Physician0101229796VA

General Provider Information

NPI Number : 1558365361
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE CATHERINE LYNAM M.D.
Provider Business Mailing Address
First Line : 9327 MIDLOTHIAN TPKE
Second Line : STE 2-C
City : RICHMOND
State : VA
Zip : 23235-4944
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7101 JAHNKE RD
Second Line :
City : RICHMOND
State : VA
Zip : 23225-4017
Country : US
Telephone Number : 804-272-6117
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 07/08/2007

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