Individual
MICHELLE KATHLEEN BOZARTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
12200 WARWICK BLVD, SUITE 410, NEWPORT NEWS, VA 23601-2344
(757) 534-5200
(757) 534-5830
Mailing address
856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0110002536
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386847333
—
VA
Enumeration date
06/07/2007
Last updated
09/30/2013
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