MEDICARE: DR. MICHAEL SOLOMON LAVA M.D.

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	207RP1001X	Pulmonary Disease Physician	70505	GA
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	70505	GA

General Provider Information

NPI Number	:	1861718272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL SOLOMON LAVA M.D.

Provider Business Mailing Address
First Line	:	120 STONEBRIDGE PKWY STE 320
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30189-3769
Country	:	US
Telephone Number	:	770-422-1372
Fax Number	:	770-423-9651

Provider Business Practice Location Address
First Line	:	120 STONEBRIDGE PKWY STE 320
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30189-3769
Country	:	US
Telephone Number	:	770-422-1372
Fax Number	:	770-423-9651

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

Provider Enumeration Date	:	04/09/2010
Last Update Date	:	01/13/2026

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