MEDICARE: MICHAEL FRANCIS NIGRO JR. 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
1	208600000X	Surgery Physician	0101029682	VA

General Provider Information

NPI Number	:	1487647152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL FRANCIS NIGRO JR. MD

Provider Business Mailing Address
First Line	:	4660 KENMORE AVE
Second Line	:	STE 220
City	:	ALEXANDRIA
State	:	VA
Zip	:	22304-1313
Country	:	US
Telephone Number	:	703-823-5900
Fax Number	:	703-751-1849

Provider Business Practice Location Address
First Line	:	4660 KENMORE AVE
Second Line	:	STE 220
City	:	ALEXANDRIA
State	:	VA
Zip	:	22304-1313
Country	:	US
Telephone Number	:	703-823-5900
Fax Number	:	703-751-1849

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2005
Last Update Date	:	11/20/2007

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