Healthcare Provider Details

I. General information

NPI: 1013440122
Provider Name (Legal Business Name): DR. MICHAEL FEREBEE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2017
Last Update Date: 08/11/2021
Certification Date: 08/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1602 SKIPWITH RD
RICHMOND VA
23229-5205
US

IV. Provider business mailing address

1602 SKIPWITH RD
RICHMOND VA
23229-5205
US

V. Phone/Fax

Practice location:
  • Phone: 757-329-3754
  • Fax:
Mailing address:
  • Phone: 804-289-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number010271465
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101271465
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: