Individual
DR. VICTOR HERBERT MICKUNAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1909 GRANBY ST, NORFOLK, VA 23517-2349
(757) 640-0022
(757) 627-8064
Mailing address
1909 GRANBY ST, NORFOLK, VA 23517-2349
(757) 640-0022
(757) 627-8064
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
0101044606
VA
208000000X
Pediatrics Physician
Primary
0101044606
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006717331
—
VA
01
—
13017
OPTIMA
VA
01
—
331437
ANTHEM
VA
Enumeration date
05/05/2006
Last updated
04/23/2026
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