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General NPI Number Information
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NPI Number | 1487623906
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Entity Type | Individual
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Provider Name | MICHAEL W. GEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 06/04/2025
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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 | 757-963-7729
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Fax | 757-470-5665
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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 | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 0101265990
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101265990
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License Number State | VA
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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 | 0101265990
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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License Number | 0101265990
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License Number State | VA
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