Healthcare Provider Details

I. General information

NPI: 1497379903
Provider Name (Legal Business Name): MICHAEL TSENG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2020
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6354 WALKER LN STE 400
ALEXANDRIA VA
22310-3252
US

IV. Provider business mailing address

6354 WALKER LN STE 400
ALEXANDRIA VA
22310-3252
US

V. Phone/Fax

Practice location:
  • Phone: 844-466-8244
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number0101288936
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: