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General NPI Number Information
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NPI Number | 1356186787
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Entity Type | Organization
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Legal Business Name | ADVANCED HEALTH CARE AND WELLNESS LLC
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Dates
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Enumeration Date | 06/27/2024
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 100 CONSTITUTION DR STE 217
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-6799
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Country | US
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Telephone | 757-963-7729
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Fax | 757-470-5665
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Provider Business Mailing Address
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Address Line | 100 CONSTITUTION DR STE 217
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-6799
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Country | US
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Telephone | 559-977-1489
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Fax | 559-272-0308
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MICHAEL GEN
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Credential | MD
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Telephone | 559-977-1489
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number |
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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Taxonomy #4
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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Taxonomy #5
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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Taxonomy #6
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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