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General NPI Number Information
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NPI Number | 1750887436
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Entity Type | Individual
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Provider Name | MICHELLE ANNE GEORGIA DO
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Gender | Female
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Dates
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Enumeration Date | 04/02/2018
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 601 CHILDRENS LN
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City | NORFOLK
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State | VA
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Zip | 23507-1910
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Country | US
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Telephone | 757-668-7874
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Fax | 757-668-8658
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Provider Business Mailing Address
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Address Line | 9960 MAYLAND DR STE 300
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City | HENRICO
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State | VA
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Zip | 23233-1485
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Country | US
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Telephone | 800-533-1560
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Fax | 800-533-1560
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 0102206716
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | 0102206716
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License Number State | VA
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