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NPI Code Detail

MEDICARE: PAUL JOSEPH MICALE MD

MEDICARE: PAUL JOSEPH MICALE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician0101039574VA
2207RI0011XInterventional Cardiology Physician0101039574VA

General Provider Information

NPI Number : 1316933195
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL JOSEPH MICALE MD
Provider Business Mailing Address
First Line : 856 J CLYDE MORRIS BLVD
Second Line : SUITE A
City : NEWPORT NEWS
State : VA
Zip : 23601-1318
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 500 J CLYDE MORRIS BLVD
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23601-1929
Country : US
Telephone Number : 757-594-2074
Fax Number : 757-594-3369
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2005
Last Update Date : 01/30/2014

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