MEDICARE: DR. MICHAEL A MCCULLEN MD

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
1	208M00000X	Hospitalist Physician	ME128433	FL
2	207R00000X	Internal Medicine Physician	0101236764	VA
3	207R00000X	Internal Medicine Physician	ME128433	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578531513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL A MCCULLEN MD

Provider Business Mailing Address
First Line	:	4000 COLISEUM DR
Second Line	:	STE 445
City	:	HAMPTON
State	:	VA
Zip	:	23666-5906
Country	:	US
Telephone Number	:	757-827-2127
Fax Number	:	757-827-2255

Provider Business Practice Location Address
First Line	:	4000 COLISEUM DR
Second Line	:	STE 445
City	:	HAMPTON
State	:	VA
Zip	:	23666-5906
Country	:	US
Telephone Number	:	757-827-2127
Fax Number	:	757-827-2255

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	03/28/2025

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Directions to “ DR. MICHAEL A MCCULLEN MD” Practice Location

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