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Individual

MICHELLE BRODASKY COVILI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
477 MCLAWS CIR STE 1, WILLIAMSBURG, VA 23185-6316
(757) 984-9650
(757) 510-9232
Mailing address
477 MCLAWS CIR STE 1, WILLIAMSBURG, VA 23185-6316
(757) 984-9650
(757) 510-9232

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102206488
VA
207Q00000X
Family Medicine Physician
OS12513
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
012038800
FL
01
14UW2
FLORIDA BLUE
FL
Enumeration date
08/07/2013
Last updated
03/18/2021
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