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General NPI Number Information
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NPI Number | 1215917406
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Entity Type | Individual
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Provider Name | MICHAEL CHARLES KING D.O.
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Gender | Male
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 06/03/2020
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Provider Practice Location Address
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Address Line | PSC 490 BOX 7716
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City | FPO
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State | AP
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Zip | 96538-1600
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Country | US
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Telephone | 671-487-4611
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Fax |
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Provider Business Mailing Address
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Address Line | NAVAL MEDICAL CENTER PORTSMOUTH 620 JOHN PAUL JONES CIR
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City | PORTSMOUTH
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State | VA
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Zip | 23708
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Country | US
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Telephone | 757-953-1197
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | DOS-1085
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License Number State | HI
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