Healthcare Provider Details

I. General information

NPI: 1548972375
Provider Name (Legal Business Name): MICHAEL ANTHONY AURIGEMA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2022
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 TIDEWATER DR STE A
NORFOLK VA
23504-3300
US

IV. Provider business mailing address

850 TIDEWATER DR STE A
NORFOLK VA
23504-3300
US

V. Phone/Fax

Practice location:
  • Phone: 757-333-6992
  • Fax:
Mailing address:
  • Phone: 757-333-6992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0110009506
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: