Healthcare Provider Details

I. General information

NPI: 1407483894
Provider Name (Legal Business Name): MICHAEL SAVAL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 01/15/2024
Certification Date: 01/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 PETERS CREEK RD STE 110
ROANOKE VA
24019-4060
US

IV. Provider business mailing address

712 W VALLEY DR
KINGSPORT TN
37664-5730
US

V. Phone/Fax

Practice location:
  • Phone: 800-765-7130
  • Fax:
Mailing address:
  • Phone: 301-674-5308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4514
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0102207488
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: