Individual
MICHAEL LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
96 15TH ST NW STE 111, NORTON, VA 24273-1600
(276) 439-1871
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 952-2111
(423) 282-1657
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101283381
VA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/06/2018
Last updated
11/28/2024
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