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Individual

MICHAEL L GENCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4092 FOXWOOD DR, SUITE 101, VIRGINIA BEACH, VA 23462-5225
(757) 467-4200
Mailing address
PO BOX 7549, PORTSMOUTH, VA 23707-0549
(757) 686-3508

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101227781
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5843723
VA
Enumeration date
06/20/2006
Last updated
04/08/2010
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