Healthcare Provider Details

I. General information

NPI: 1336108364
Provider Name (Legal Business Name): MICHAEL EARL PARKER M.D,M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 CARPENTER RD
FORT MYER VA
22211-1009
US

IV. Provider business mailing address

2530 CRYSTAL DR, SUITE 12039 SAIG-TI
ARLINGTON VA
22202
US

V. Phone/Fax

Practice location:
  • Phone: 703-696-3552
  • Fax:
Mailing address:
  • Phone: 703-545-0881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number12808R
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number12808R
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number12808R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: