Healthcare Provider Details

I. General information

NPI: 1881016541
Provider Name (Legal Business Name): MICHAEL JOHN SOLHAUG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2014
Last Update Date: 01/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5203 HOLLY RD
VIRGINIA BEACH VA
23451-2330
US

IV. Provider business mailing address

5203 HOLLY RD
VIRGINIA BEACH VA
23451-2330
US

V. Phone/Fax

Practice location:
  • Phone: 757-446-5638
  • Fax: 757-624-2269
Mailing address:
  • Phone: 757-446-5638
  • Fax: 757-624-2269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License Number0101031026
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: