Individual
MICHAEL R. KONIKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7240
(757) 668-7721
Mailing address
PO BOX 79137, BALTIMORE, MD 21279-0137
(757) 668-7200
(757) 668-9691
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101239467
VA
2080P0206X
Pediatric Gastroenterology Physician
Primary
0101239467
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010259525
—
VA
Enumeration date
06/16/2006
Last updated
12/16/2009
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