Individual
MICHELE WADSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2117 MCCOMAS WAY, STE. 103, VIRGINIA BEACH, VA 23456-3908
(757) 668-6715
(757) 668-6680
Mailing address
2117 MCCOMAS WAY, STE. 103, VIRGINIA BEACH, VA 23456-3908
(757) 668-6715
(757) 668-6680
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101049021
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
237158
ANTHEM BCBS,HK,HK,FAMIS
VA
01
—
35381
OPTIMA,FAMILY CARE,FAMIS
VA
01
—
541778786
NC HEALTH CH
NC
01
—
5417787860686E
CIGNA
VA
01
—
637669
ALLIANCE,MAMSI,MDIPA,
VA
05
—
6739784
—
VA
05
—
890618K
—
NC
Enumeration date
07/17/2006
Last updated
07/21/2022
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